Highlights | A safe and effective option
- Telemedicine abortion allows providers to guide patients through their medication abortion via telehealth services.
- There are no increased risks for using telemedicine for an abortion.
- Telemedicine doesn’t replace in-office care if needed, and the patient will work with their provider to determine what’s right for them.
When it comes to abortion access, barriers such as location, childcare, work and more can prevent someone from going into a clinic for the procedure.
“Many people have difficulty accessing abortion, even in a state like Washington that continues to support access to abortion,” says Sarah Prager, MD, an OB-GYN and director of the Family Planning Division and Family Planning Fellowship at UW Medicine. “Some of the access issues can be alleviated by avoiding an in-person visit.”
UW Medicine’s telemedicine abortion service, a medication abortion via telehealth, is one way barriers to abortion access are being addressed.
Prager says anyone with a physical address in Washington State can access this service, limiting some of these barriers to abortion access by eliminating a patient’s need for significant travel, reducing time away from work or school, or needing to find childcare.
Understanding how telemedicine abortion works
Telemedicine abortion is a form of what’s called “no touch” abortion, explains Prager, as it forgoes any patient testing — such as blood type, blood count and ultrasounds for gestational dating — before accessing the abortion.
UW Medicine protocols state that if a patient can be sure of their last menstrual period, have had a positive home pregnancy test, and do not have any risk factors for ectopic pregnancy (e.g., current pelvic pain or bleeding, a prior ectopic pregnancy, a current intrauterine device, aka IUD placement or prior tubal ligation), patients are considered a safe candidate for telemedicine abortion.
With the guidance of their provider, patients will have a medication abortion, which typically involves a combination of the drugs mifepristone and misoprostol.
“The telehealth visit is used to take a patient history to ensure there are no concerns for a pregnancy that would require an in-person visit,” she says. “The medications for the abortion are prescribed and then mailed to the patient.”
While other clinics offer this service, such as family planning clinics like Planned Parenthood, UW Medicine is one of the few academic centers in the country that provides this service.
“With all the different state laws, patients are really confused about what is or is not legal and available in their area,” says Emily Godfrey, MD, a professor of family medicine and obstetrics and gynecology at the University of Washington School of Medicine. “UW Medicine is a name that every patient in the region can trust, so it’s crucial that we offer this essential healthcare service.”
Telemedicine abortion is low risk
Prager and Godfrey emphasize that telemedicine abortion is safe and effective. There are no increased risks to using telemedicine for an abortion if patients have no signs or symptoms of a high-risk pregnancy, such as ectopic pregnancy, where the fertilized egg implants outside the uterine cavity.
“A telehealth visit will never replace a physical exam or other in-person evaluation,” says Prager, “but most of the time, this isn’t needed for safe and effective care.”
Current and future telemedicine abortion services at UW Medicine
Patients can now access telemedicine abortion through the family planning clinics at UW Medicine Primary Care at Northgate, Women’s Health Care Center at UW Medical Center – Roosevelt and UW Medical Center – Northwest. In the long term, there is hope that more providers at UW Medicine locations can offer the service.
“Ultimately, a broader scope of UW Medicine providers and clinics will be able to also offer these services, which will allow patients to have more choice in both how their abortion is done and who they choose as their clinician,” says Prager.
Prager says the UW School of Medicine Department of Obstetrics and Gynecology and the Department of Family Medicine plans to offer joint session webinars on telemedicine abortion. They will be designed to educate interested reproductive healthcare and primary care clinicians on how to provide telemedicine abortions. And one day, there’s a hope that patients will have a breadth of providers they can turn to for abortion services — widening the number of options patients have when making decisions about their healthcare.
