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Abortions can be provided safely and effectively using telehealth

During the COVID-19 pandemic, a federal judge temporarily suspended enforcement of FDA requirements that the abortion medication, mifepristone, be dispensed in clinics, medical offices, or hospitals. Soon after, a virtual abortion clinic began providing care. UCSF analysis found no major adverse events and a 95% efficacy rate, similar to in-person provision.

Key Findings

Between October 2020 and January 2021, the clinic provided fully remote, asynchronous medication abortion care for 141 patients.
Among 110 patients for whom abortion outcomes were collected, 95% had a complete abortion without intervention. 5% required medical care to complete the abortion, and no patients reported any major adverse events.
The efficacy rate is similar to in-person provision, suggesting that abortion provided via telehealth is feasible and safe.

Study Design

Researchers conducted a retrospective cohort study of patients who used a virtual clinic called Choix, which began providing abortion services via telehealth in California during the suspension of enforcement of FDA requirements. Choix shared de-identified health record data for all patients with the ANSIRH research team, who analyzed efficacy, safety and outcomes.

Implications

These results represent some of the earliest data on new telehealth abortion clinics in the United States. They show that telehealth medication abortion care, without routine pre-abortion ultrasound and with delivery by mail-order pharmacy, is safe and effective.

These data can inform the FDA’s pending decision about permanently lifting its in-person dispensing requirement. This study can also help clinicians who are considering providing telehealth or no-test medication abortion care to understand that patient outcomes are similar to those associated with in-person care.

The article, Safety and Efficacy of Telehealth Medication Abortions in the U.S. During the COVID-19 Pandemic, is available in JAMA Network Open.