Providing abortion by telehealth—the first 1000 medical abortions safe and effective
Associate Professor Suzanne Belton says, 'Telehealth abortions with tablets are a safe and effective way for Australian women to seek a termination of pregnancy.'
'It is a low-risk procedure. Very few women needed extra support at a hospital for assistance with bleeding or additional pain relief.'
'Women can use a telephone medical abortion service to speak with doctors and nurses to get information, tests and medications. So far more than 1000 women have used the service which is very affordable, since September 2015.'
According to a spokesman for the Tabbot Foundation, telemedicine is ideal for this type of service as there is no need – beyond a blood test and ultrasound – for a physical examination.
'I am very pleased to see the research data showing excellent clinical outcomes for women. Nearly all patients had a normal medical abortion process,' the medical director, Dr Paul Hyland, said.
'What we need to work on with the government is getting a Medicare rebate for women who use the telehealth option."
The Tabbot Foundation has an average time between the date of first contact and date of abortion at 10 days.
The seven-step process, costs $250 with a Medicare card, starts when women call a 1800 number and are referred for an ultrasound and blood test. Based on these results, Tabbot Foundation organises a telephone consultation with a medical professional and, if necessary by state law, a clinical psychologist.
"The doctors are either specialist gynaecologists or GPs with family planning experience," Dr Hyland said.
Patients are mailed medications, not only mifepristone and misoprostol (MS-2Step) but also antibiotics, analgesics and anti-nausea medicines. The patient is guided through the abortion process by a registered nurse and a 24-hour on-call doctor.
A blood test 10 days later confirms whether the termination has been successful.
The patients come from across Australia (excluding South Australia where the state's legislation restricts telemedicine). About 15 per cent are from rural and remote areas in which there has previously been no easy access to abortion.
Dr Belton said, 'Telehealth abortion can reduce health care costs and remove some of the barriers that women in regional and rural areas face in seeking reproductive health care.'
'Using the telephone services ensures that women avoid possible obstruction and intimidation and harassment from protestors outside known abortion clinics.'
Although the Tabbot Foundation is the first in the world to offer the service via telehealth, medical abortion itself has been around since the 1980s, and the trend continues with over 80% in Norway, 60% in Scotland, 40% in England and 25% in USA.