Despite some state bans, study shows few complications with telemedicine-based medication abortion

Of the nearly 20,000 patients studied, only 49 complications were reported, and there was no difference in the complication rate between women who had an in-person visit.
By Bill Siwicki
02:27 PM
telemedicine-based medication abortion

Medication abortion provided by telemedicine is just as safe as when women are in the same room as the physician, according to a new study from the University of California San Francisco and Ibis Reproductive Health. 

It’s important to distinguish between a medication abortion, which involves taking a pill very early in a pregnancy, and abortions that require a procedure. 

The study examined data from patients in Iowa who received a medication abortion either via telemedicine or in person from 2008 to 2015. The study included any reports of serious complications, including visits to the emergency department where treatment was given. Of the nearly 20,000 patients studied, only 49 complications were reported, and there was no difference in the complication rate between women who had an in-person visit and those who received the service via telemedicine. 

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“This study included a large number of patients, so we can definitively conclude that telemedicine provision of medication abortion is not associated with a higher risk of complications compared with in-person provision,” said Daniel Grossman, MD, the director of Advancing New Standards in Reproductive Health at the university and a co-author of the study. “These findings add to our previous research demonstrating that telemedicine medication abortion was just as effective as meeting with the physician in person, and satisfaction was also high among the women studied.”

The same evaluation was given to women who received abortion care through telemedicine as those who received care with an in-person visit, including having an ultrasound, which was viewed remotely by the physician. The doctor met with the patient by secure video conference, and if she was eligible, the doctor remotely dispensed the medication. Women returned to the clinic about one week later for a follow-up.

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Eighteen states have banned the use of telemedicine to provide abortions, citing concerns about safety. In 2008, Planned Parenthood of the Heartland in Iowa began offering medication abortion at health centers without a physician on site in order to improve access to abortion for those living in areas with few or no abortion providers.

The Iowa Board of Medicine imposed a regulation in 2013 that prohibited telemedicine medication abortions. Planned Parenthood filed a legal challenge and in 2015 the Iowa Supreme Court issued a unanimous ruling blocking the regulation and allowing telemedicine abortion care to continue.

“Our findings provide additional evidence that there is no justification to restrict access to medication abortion by banning the use of telemedicine to provide the service,” Grossman said. “In fact, our previous research found that the telemedicine service in Iowa improved access to early abortion and was associated with a reduction in second-trimester abortion.”

The study’s co-author Kate Grindlay, an associate at Ibis Reproductive Health, said medication abortion said that telehealth technologies are a good fit for this type of consult. 

“Now we have clear evidence of the safety of this model of care,” Grindlay said. 

The study was published online in Obstetrics & Gynecology, the official journal of the American College of Obstetricians and Gynecologists, and will appear in print Sept. 21.

Twitter: @SiwickiHealthIT
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