NYC Public Health System Launches Virtual Abortion Access

In a first nationwide, New York City's public healthcare system has extended medication abortion access via its ExpressCare telehealth service.

NYC Health + Hospitals launched a telehealth abortion service, becoming the first public health system in the United States to offer one.

The service, available through Virtual ExpressCare, aims to expand access to abortion care across New York City. Residents can schedule an on-demand virtual appointment to speak with a healthcare professional by video or phone for an assessment and counseling. In a few days, they will receive a medication abortion kit at their home if clinically appropriate.

"As our country faces a devastating loss of reproductive rights, New Yorkers should know that they can access safe and legal abortion care from NYC Health + Hospitals," said Marisa Nádas, MD, reproductive health clinical lead at NYC Health + Hospitals and associate medical director of Virtual ExpressCare, in the press release. "By offering access to assessment and counseling for abortion care – as well as the possibility of a remote medication abortion – through Virtual ExpressCare, we are navigating around barriers people face in coming for in-person appointments and further opening up access."

NYC Health + Hospitals, the largest municipal healthcare system in the US, launched Virtual ExpressCare in 2020 to ensure continuity of care during the COVID-19 pandemic. Through the service, NYC residents can access urgent care for health issues that are not life-threatening via audio and video technology. The service includes on-screen interpreters that speak more than 200 languages. Last year, the health system added telemental health services to Virtual ExpressCare.

Now, with the addition of the virtual abortion service, NYC residents can connect with healthcare professionals seven days a week to receive abortion care. Residents up to 10 weeks into their pregnancy and clinically eligible can receive medication abortion services virtually.

Telehealth-enabled medication abortions have spiked since the 2022 Dobbs ruling that overturned Roe v Wade, allowing states to severely restrict abortion access.

Data from the Society of Family Planning shows that telehealth abortions comprised 5 percent of all abortions before the Dobbs decision and rose to 9 percent of all abortions post-Dobbs, representing an 85 percent increase.

Research shows that telehealth abortions are generally safe and effective. For example, earlier this year, a study published in npj Digital Medicine found that telehealth was as effective as in-person abortion services while limiting the need for surgery, supporting providers, and boosting convenience.

Additionally, an internal assessment conducted by Hey Jane, an asynchronous telehealth abortion provider, shows that its overall serious adverse event rate in 2022 was 0.16 percent, compared to the national average in scientific literature, ranging from 0.31 percent to 0.54 percent.

Not only does research point to the safety and efficacy of telehealth abortions, but it also shows that telehealth abortions are associated with high patient satisfaction.

A study published in March revealed that medication abortions delivered via telehealth provided benefits to patients absent from in-person services. Conducted by University of Washington School of Medicine researchers, the study included 30 patients who sought medication abortions in Washington state between September 2021 and January 2022. Of these patients, 20 used telehealth to access abortion care.

Researchers found that despite high satisfaction across the patient population, telehealth patients experienced a higher level of relaxation. In contrast, in-person patients reported that their visits were lengthy, chaotic, and lacking comfort.