Telehealth medication abortion services ease access to care for underserved US communities

Key takeaways:

• Women farther from the clinic or with at least one prior abortion were more likely to have telehealth medication abortion services.
• Black women were more likely to have in-clinic medication abortion care.

Telehealth medication abortion services help make abortion care access more convenient and accessible for underserved communities in the U.S., according to a cross-sectional study published in JAMA Network Open.

“Due to limited in-clinic access throughout the country, telehealth medication abortion services, including online consultations and medications delivered directly to patients, can make abortion care more convenient and accessible,” Anna E. Fiastro, MPH, MEM, PhD, research scientist in the department of family medicine at the University of Washington, Seattle, and colleagues wrote. “Other areas of health care have documented disparities in telehealth access, although less is known about telehealth medication abortion services.”

Fiastro and colleagues evaluated electronic medical record data from 1,241 women (mean age, 30 years) who were telehealth medication abortion patients or telehealth medication abortion eligible. All women received in-clinic medication abortion services at Cedar River Clinics in Washington from April 2020 to January 2022. Researchers assessed associations between patient characteristics and odds of receiving telehealth medication abortion services compared with in-clinic services.

Overall, 69% of study participants had in-clinic visits for medication abortion services and 31% received telehealth medication abortion services. Women who lived farther away from the clinic (adjusted OR = 1.02; 95% CI, 1.01-1.03) with at least one prior abortion (aOR = 1.63; 95% CI, 1.2-2.22) had a higher likelihood of choosing to use telehealth medication abortion services.

Women who self-reported as multiracial or other race had a higher likelihood of choosing to use telehealth medication abortion services compared with white women (aOR = 4.52; 95% CI, 2.78-7.34). In addition, Black women had a higher likelihood of choosing in-clinic medication abortion services compared with other races (aOR = 0.61; 95% CI, 0.39-0.95).

In addition, researchers noted that the following women were less likely to choose telehealth vs. in-clinic medication abortion services:

• women younger than 20 years (aOR = 0.49; 95% CI, 0.26-0.92);
• aged 21 to 25 years (aOR = 0.35; 95% CI, 0.22-0.57);
• aged 26 to 30 years (aOR = 0.6; 95% CI, 0.4-0.9);
• non-English speaking women (aOR = 0.06; 95% CI, 0.02-0.26); and
• women with one (OR = 0.24; 95% CI, 0.15-0.38) or more health conditions (aOR = 0.19; 95% CI, 0.12-0.31).

“As access to abortion care continues to be restricted in the U.S., innovative models of care delivery are needed to accommodate the sustained demand for services and to meet the needs of diverse patient populations,” the researchers wrote.