Telehealth Supported Medication Abortion Services During Pandemic

To ensure continued access to care amid restrictions that resulted from the COVID-19 pandemic, many clinics turned to telehealth to provide medication abortion services, which proved to be highly effective, according to a study published in the Annals of Family Medicine.

It is a well-known fact that the COVID-19 pandemic heavily impacted healthcare delivery. Like many other types of care, reproductive healthcare and abortion services became significantly more difficult to obtain during this time.

The study evaluated how US clinics used telehealth abortion services as well as the efficacy level of these services and the patient benefits.

Researchers collected data from 14 clinics, interviewing a total of 20 clinical staff members. The practice settings included independent primary care practices, specialized family planning clinics, telehealth-only web-based clinics, and primary care clinics within health systems.

Each clinic followed a similar five-step process to offer remote medication abortion services. The five steps were engaging with patients, care consultation, payment, dispensing medications via the mail, and post-care communication.

The setting greatly influenced how the process varied, particularly regarding whether virtual care occurred synchronously or asynchronously. Researchers found that asynchronous virtual care methods were the fastest and most effective, providing services within 2 to 5 minutes, quicker than the 10 to 30 minutes it took for each synchronous virtual care session to be completed.

Family planning clinics and primary care clinics based within health systems relied on clinic stock or internal pharmacies to mail abortion medications, while independent practices and web-based clinics often used mail-order pharmacies, the study shows.

Study results showed that the five-step structure used by practice settings to provide virtual abortion care is reliable and effective.

"Given the documented success of remote abortion services, clinicians in all settings should consider ways that telehealth medication abortion can be incorporated into their primary care practices to offer comprehensive reproductive health services," the study authors concluded.

Previous research has also shown that telehealth played a key role in the increase in medication abortions in 2020. Preliminary data from the Guttmacher Institute showed that medication abortions spiked from 39 percent in 2017 to 54 percent in 2020, spurred by the increase in telehealth use.

Further, anticipating significant barriers to abortion care in the event the Supreme Court overturned Roe v Wade — which it did in June — abortion providers and federal agencies turned to telehealth to bolster access.

In December 2021, several abortion providers spoke with mHealthIntelligence, describing how they planned to use virtual care modalities to increase access to abortions in a post-Roe world. 

In May, the Department of Health and Human Services provided the Title X family planning clinic with a large grant dedicated to increasing the adoption and use of telehealth.