Primary Care Offers Safe, Positive Telehealth Abortions, Patients Say

Primary care settings provided safe, acceptable, and positive telehealth medication abortion experiences for patients, new research published in the Annals of Family Medicine shows.

Conducted by researchers at the University of Washington Medicine (UW Medicine), Cambridge Health Alliance, Planned Parenthood of Orange and San Bernadino counties, and the Reproductive Health Access Project, the study explored patient experiences and perspectives on obtaining telehealth medication abortions through their primary care networks.

Following the 2022 Supreme Court decision to eliminate the federal constitutional right to abortion, 14 states banned abortions, four states placed gestational limits between six and 12 weeks on abortions, and seven states set gestational limits between 15 and 22 weeks, according to KFF data. In this increasingly restrictive landscape, telehealth has become an increasingly popular way to access abortion medications.

Telehealth medication abortions (teleMAB) involve a telehealth visit through which a patient receives an e-prescription for pregnancy termination drugs, like Mifepristone and Misoprostol.

In the new study, researchers interviewed patients who received teleMAB within a large primary care safety-net community health system in Massachusetts. They identified 47 patients who received a TeleMAB between July 28, 2020, and December 31, 2021, had medications delivered, and spoke and understood English, Spanish, or Portuguese. Of these, 14 agreed to be interviewed.

Participants described their experience with teleMAB services with their primary care system as acceptable, positive, and easy. Participants noted the ease of process, clear communication, non-judgmental interactions, and continuity of care associated with the service.

Further, participants stated that teleMAB within the primary care setting increased feelings of autonomy, flexibility, and comfort.

“I think the big takeaway is that primary care can absolutely do telemedicine and provide medication abortion,” said study senior author Emily Godfrey, MD, a family medicine and OB-GYN physician with UW Medicine, in a press release.

Participants also noted how teleMAB reduced barriers to care. They described decreased interruptions to their daily lives, increased agency over their chosen surroundings, and access to preferred coping mechanisms.

“I could be a lot more vulnerable because I was right in my bed. And then you didn’t have to worry about crying or wiping your face up and seeing people after that,” one participant said. “Or people overhearing you in the office or something. You were just at home so you could just be like… this is worrying me.”

Not only that, but participants stated that abortion should be part of routine primary care. They said they felt comfortable knowing that their abortion providers had access to their medical histories, and independent abortion clinics seemed more isolating.

Participants had positive experiences receiving teleMAB from their own primary care physician or another PCP within the same practice or system. But when challenging situations arose, they said that established relationships with one’s PCP helped mitigate the impact.

“I think our study really highlights that many patients were seen throughout prior pregnancies in their primary-care system and appreciated being able to see the same doctors in the same system for their abortion care,” said study co-author Anna Fiastro, PhD, a researcher in the UW School of Medicine’s family medicine department, in the press release. “It made them feel more comfortable with the process.”

The research aligns with study findings published last year. According to research in the journal Obstetrics & Gynecology, patients had better experiences obtaining medication abortions via telehealth than in person. The study involved interviews with 30 patients who sought medication abortion in Washington state between September 2021 and January 2022.

Of the patient population, 20 used telehealth, and ten used in-person care. Though both groups were satisfied with their care, researchers found that telehealth patients experienced more relaxation, while in-person patients reported that their visits were lengthy, chaotic, and lacking comfort.