Medication abortion can be delivered safely and effectively through telemedicine, according to new research from UC San Francisco. Researchers analyzed data from more than 6,000 patients who obtained abortion pills from virtual clinics in 20 states and Washington D.C. between April of 2021 and January of 2022. They found there were no serious adverse events 99.8% of the time, and that abortions did not require follow-up care 98% of the time. This is similar to what has been found for patients who receive medication abortion at clinics or doctor’s offices.
The findings appeared Feb. 15, 2024, in Nature Medicine.
Medication abortion, which now accounts for more than half of all abortions, involves taking two pills – mifepristone followed by misoprostol – and extensive research supports its safety and efficacy. Demand for the pills has increased since more than two dozen states banned or restricted abortion following the June 2022 decision by the Supreme Court to overturn Roe v. Wade, which guaranteed a constitutional right to abortion.
In 2021, the agency removed the in-person dispensing requirement, allowing health care providers to have abortion pills sent through the mail after an online consultation. Telehealth abortion now accounts for nearly 10% of all U.S. abortions.
“This research confirms that the FDA followed science in allowing patients to get medication abortion through telehealth and the mail,” said the study’s first author, Ushma Upadhyay, PhD, MPH, a public health scientist with Advancing New Standards in Reproductive Health (ANSIRH) at UCSF.
Telemedicine promotes privacy and access
The researchers also compared video visits to secure text messaging, and found they were about equally safe and effective. The authors concluded that telehealth protects patient privacy while making abortion more accessible. This has become increasingly important as abortion clinics have closed in states that restricted abortion and wait times have increased elsewhere.
“Since the COVID-19 pandemic, telemedicine has become the new frontier in health care, including for medication abortion,” said Upadhyay, who is a professor of Obstetrics, Gynecology & Reproductive Sciences at UCSF. “Any future Supreme Court ruling against this method and the FDA’s rigorous science review process would be a huge blow to the American public and make this essential health service harder to get.”
The study was recently cited in an amicus brief submitted to the Supreme Court supported by more than 300 leading reproductive health researchers in Food and Drug Administration v. Alliance for Hippocratic Medicine, where the Court rejected an attempt to restrict access to the abortion pill mifepristone, but did so on procedural grounds.
Authors: Additional UCSF co-authors include Leah R. Koenig, MSPH, Karen Meckstroth, MD, MPH, Jennifer Ko, MLIS, and M. Antonia Biggs, PhD.
Funding and Disclosures: The CHAT Study was supported by the BaSe Family Fund, Erik E. and Edith H. Bergstrom Foundation, Isabel Allende Foundation, Jess Jacobs, Kahle/Austin Foundation, Lisa and Douglas Goldman Fund, Preston-Werner Ventures, and a Resource Allocation Program Award from the UCSF National Center of Excellence in Women’s Health.
About ANSIRH: Advancing New Standards in Reproductive Health (ANSIRH), based at the University of California, San Francisco, conducts rigorous scientific research on issues related to reproductive health in the United States and internationally. ANSIRH provides much-needed evidence for active policy debates and legal battles around abortion and reproductive health topics. To learn more, please visit www.ansirh.org.
About UCSF Health: UCSF Health is recognized worldwide for its innovative patient care, reflecting the latest medical knowledge, advanced technologies and pioneering research. It includes the flagship UCSF Medical Center, which is a top-ranked hospital, as well as UCSF Benioff Children’s Hospitals, with campuses in San Francisco and Oakland; Langley Porter Psychiatric Hospital and Clinics; UCSF Benioff Children’s Physicians; and the UCSF Faculty Practice. These hospitals serve as the academic medical center of the University of California, San Francisco, which is world-renowned for its graduate-level health sciences education and biomedical research. UCSF Health has affiliations with hospitals and health organizations throughout the Bay Area. Visit https://ucsfhealth.org. Follow UCSF Health on Facebook or on Twitter.
