Medication abortion provided at home with telehealth is a safe and effective option, according to a new study published in Nature Medicine. The study, which surveyed over 6,000 remote medication abortions between April 2021 and January 2022, found that only 0.25 percent of patients experienced adverse outcomes such as excessive bleeding or infection. Less than 2.5 percent of patients experienced a continued pregnancy.
The combination of mifepristone and misoprostol, the two-drug regimen commonly used for medication abortion, has been proven to be safe and effective for terminating pregnancies. The study’s lead author, Ushma Upadhyay, a quantitative public health scientist at the University of California, San Francisco, states that providing telehealth care for medication abortion is just as safe and effective as in-person care.
The study evaluated both synchronous and asynchronous care. Synchronous care involves real-time communication between the patient and healthcare provider via phone or video chat, while asynchronous care does not require real-time interaction. The researchers found that both approaches had equally successful outcomes. Kelly Cleland, executive director of the American Society for Emergency Contraception, highlights that asynchronous care improves access to abortion care, especially for individuals living in rural areas with limited Wi-Fi access or facing threats of violence from intimate partners.
Medication abortion plays a significant role in the US, accounting for more than half of all abortions, according to a survey by the Guttmacher Institute. It is a crucial form of healthcare for individuals who lack easy access to abortion clinics or live in areas where abortion is illegal. With the ongoing COVID-19 pandemic and increasing restrictions on care options, experts predict that the percentage of medication abortions will continue to rise in the coming years.
Despite the proven safety of medication abortion, both mifepristone and misoprostol have faced scrutiny and regulatory challenges. The Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade, has further intensified these challenges. The upcoming Supreme Court case could jeopardize mifepristone’s FDA approval and potentially ban its use.
Under current guidelines, mifepristone should be prescribed by a certified healthcare provider to patients within 10 weeks of pregnancy. The FDA expanded the drug’s approval in 2021 to include telehealth prescriptions, which proved vital during the height of the COVID-19 pandemic. However, anti-abortion advocates filed a lawsuit challenging the updated guidelines and mifepristone’s initial FDA approval in 2000. Many healthcare providers argue that the lawsuit lacks scientific basis and is politically motivated.
Healthcare experts are concerned that a decision in favor of the plaintiffs could undermine the FDA’s authority to evaluate other drugs. Silpa Srinivasulu, a public health researcher at the Reproductive Health Access Network, emphasizes that the obstacles faced by medication abortion are not grounded in science but are politically motivated attacks.
The new research provides crucial evidence supporting the FDA’s decision to expand telehealth options for medication abortion. Upadhyay hopes that the Supreme Court will consider this evidence when making its decision. The study’s findings highlight the importance of preserving access to safe and effective abortion care, particularly in a time when healthcare options are increasingly restricted.
