The TelAbortion Project: Delivering the Abortion Pill to your Doorstep by Telemedicine and Mail [5E]

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Abstract

INTRODUCTION:

In the United States, many women struggle to obtain an abortion due to ever-increasing barriers to access. The TelAbortion Project provides medical abortion directly to women in their homes using telemedicine and mail, enabling them to receive services without going to a clinic. We will report data from the pilot phase of this project, which will be completed by October 2017.

METHODS:

TelAbortion was available in Hawaii, New York, Oregon, and Washington. Interested women contacted implementing sites and interacted with clinicians by videoconference. After obtaining screening tests at radiology and lab facilities close to them, eligible women were mailed packages containing mifepristone and misoprostol. Women took the medications at home, obtained follow-up tests and had another consultation with the clinician.

RESULTS:

Through August 2017, 105 women had a videoconference, 93 had received abortion drugs, and 60 had completed follow-up. Among women who took mifepristone and misoprostol, one had a surgical completion, and no serious adverse events were reported. All women reported being very satisfied or satisfied, and 59 of 60 would recommend this service to a friend. Convenience and privacy were commonly valued features.

CONCLUSION:

Direct-to-patient telemedicine abortion is feasible and can potentially increase access to abortion care in a safe and acceptable manner. Although telemedicine bans and other restrictions are on the rise, more than 60% of all abortions in the US are currently performed in states where this service would be legally feasible. Going forward, we plan to scale up this service to women in other states.

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