Comparing telemedicine to in-clinic medical abortion

Telemedicine is also referred to as telehealth or e-medicine. It is a general term that covers all the ways you can contact your doctor using technology to communicate your medical concerns without being in the same room. This can be done through phone calls, video calls, emails, and text messages. It is often used by people who cannot access medical services due to living in rural areas or having limited transportation. 

Abortion is an essential service; thus, some medical clinics have begun to offer medical abortion through telemedicine. This is particularly popular due to the Covid-19 crisis where you can access abortion services without violating state guidelines and maintaining social distancing. Medical abortions are done through an abortion kit like the MTP Kit which contains two medications namely mifepristone and misoprostol. Mifepristone stops the foetus from growing. It works by obstructing the activity of progesterone, a female hormone responsible to aid your pregnancy and induce contractions.Misoprostol helps to reduce the risk of excessive bleeding and protects your stomach lining by lowering the level of acid. It softens the cervix which aids the uterus to push out the pregnancy. This helps in curbing an early pregnancy.

These medications are usually taken in the presence of your healthcare provider, but through telemedicine, patients are given abortion medications safely without the traditional need for in-person pregnancy testing, ultrasound, or pelvic examinations. Doctors are able to evaluate patients remotely through a phone call or video call to determine the clinical eligibility for this service based on their health and gestational age. After the assessment, patients are told to get medical abortion kits and take them at their homes. Through telemedicine, the follow-up appointments also take place via phone or video call.

Telemedicine v/s In-Clinic Abortion

A study of 2020 conducted by the National Library of Medicine, compares the practical aspects of practicing medical abortions through telemedicine and in-person clinic visits. The study found telemedicine patients required more unscheduled communications and received ultrasounds far less often compared to in-clinic patients. It also shed light on the feasibility to provide medication abortions using telemedicine. The study did not have a large sample size to provide evidence of the safety of medical abortions but it does add to the literature about safety in a variety of settings.

In a different model by Planned Parenthood, clinics in Iowa offered abortions in which patients were asked to see a counsellor or nurse in the clinic but then see a doctor by video conferencing. This study showed no different outcomes in parent satisfaction when comparing women obtaining a medical abortion by telemedicine or face-to-face with the physician.

In a recent report, that evaluated direct-to-patient telemedicine abortion service in the United States, 248 patients received medication through mail and the researchers found the service to be safe, effective, efficient, and satisfactory. 

Medical abortions v/s surgical abortions

Many people prefer medical abortions to surgical abortions as there are more discreet and convenient.  Telemedicine is also less expensive as people do not need to travel long distances and bear the cost of a surgical abortion. Standard in-clinic abortion would include one booking telephone call and two in-person visits to the clinic while standard telemedicine abortion includes at least two phone calls and three video calls. This brings down the overall cost of getting an abortion. The only drawback of an abortion through telemedicine is not all pharmacies will dispense mifepristone, so pharmacies need to be found that will courier medications to your address. The above literature demonstrates telemedicine is safe, effective, and feasible but more research is needed on using different protocols in different settings.

Cost and availability of abortion kits

Abortion kits are readily available over the counter in pharmacies, supermarkets, and online stores. They do need a prescription and are mostly taken in a clinic in the presence of a healthcare provider. They are also available online with a small shipping charge, but in case of urgent situations delivery might take time. The price may vary depending from place to place and healthcare centre, there are generic options available that range from 180$-200$. Abortion kits you should consider are a complete abortion kit called  MTP Kit

Takeaway

Abortion can feel like a stressful step, but with proper care and help it is manageable. Several studies have reported that abortion through telemedivine is safe and effective. There is even more accessibility of abortion medivcation through various online stores that cater to these needs. With the guidance and timely appointments with your doctors, it is completely possible to successfully abort a pregnancy in the privacy of your own home for up to 10 weeks. It is a more convenient and discreet option. However, everything should be done exactly as advised by your doctor and follow-up appointments should not be skipped. In case you experience any side effects you should immediately report to your doctor.