Multiracial Individuals More Likely to Use Telehealth Abortion Services

Individuals who reported being multiracial were more likely to use telehealth to obtain medication abortion services than their White peers, according to new research published in JAMA Network Open.

Abortion access has been increasingly restricted in the United States over the last few years, first because of the COVID-19 pandemic and then due to the Supreme Court's decision to overturn Roe v. Wade. As a result, demand for medication abortions via telehealth grew.

Though the overall number of abortions decreased following the overturning of Roe, abortions provided by telehealth providers increased from 3,610 in April 2022 to 8,540 in December 2022, representing a 137-percent increase in the number of abortions provided through virtual-only services, a report from the Society of Family Planning shows.  

The new study, conducted by researchers from the University of Washington in Seattle and the University of California, Los Angeles, aimed to examine the differences between patients using telehealth for medication abortion services and those using in-clinic services.

Researchers analyzed EMR data from 1,241 individuals, of which 383 received telehealth medication abortion services (tele-MAB), and 858 received in-clinic services at a reproductive health care clinic in Washington State between April 23, 2020, and January 31, 2022.

The study shows that individuals who self-reported as multiracial or "other race" were 4.5 times more likely to use tele-MAB compared with White individuals.

However, Black individuals were an exception, as they were more likely to receive in-clinic services. Only 12 percent of the study participants receiving telehealth visits were Black, versus 20.9 percent of those receiving in-clinic services.

Similarly, those with at least one health condition, as well as younger individuals and non-English speakers, were less likely to receive tele-MAB compared with in-clinic care.

Emily Godfrey, MD, professor of family medicine and obstetrics and gynecology at UW Medicine, said in a press release that the relatively low telehealth use among younger individuals seeking abortion services may indicate that they are "wary of telehealth's legitimacy and whether getting care this way really works."

Thus, efforts to educate individuals about telehealth services and increase language support are necessary to boost the use of tele-MAB among diverse populations, the study authors wrote.

Other findings from the study were that individuals who lived further from a clinic and had at least one prior abortion were more likely to use tele-MAB. In addition, the number of living children and payment type did not differ between tele-MAB and in-clinic patients.

The researchers concluded that as telehealth is increasingly used to extend access to abortion care, "further research is needed to better understand patients who identified as multiracial or other race and how identity, including prior experiences of racism in health care settings, may impact patient preference for tele-MAB services."

Further, "innovative models of care delivery are needed to accommodate the sustained demand for services and to meet the needs of diverse patient populations," they wrote.

The study aligns with prior research showing that telehealth is an effective option for obtaining abortion care, on par with in-person services. Research also indicates patient satisfaction with telehealth abortion services is high.

Another University of Washington study published earlier this year revealed that telehealth offered patient satisfaction benefits that in-person care did not.

The study included 30 patients who sought medication abortion in Washington state between September 2021 and January 2022. Of the total patient population, 20 used telehealth, and ten received in-person care.

Though patient satisfaction was generally high across the entire population, telehealth patients experienced a higher level of relaxation. In contrast, in-person patients reported that their visits were lengthy, chaotic, and uncomfortable.