April 13, 2024

Telemedicine for abortion pills is healthy and safe, says study

Supporters of telemedicine for medication abortions have been heartened by a study published in the leading journal Nature Medicine this week. The researchers, from the University of California, San Francisco, collected date on 6,034telehealth medication abortions. They found that it “is effective, safe and comparable to published rates of in-person medication abortion care”. 

The article, which comes out of the same abortion research powerhouse which was responsible for the influential Turnaway Study, could influence the Supreme Court when it hears a case brought by opponents of medication abortion next month. They claim that telemedicine is unsafe. 

“We believe this study has huge implications for policy, in particular for the upcoming Supreme Court case on mifepristone (one of two medications used in medication abortion). This research shows that the FDA followed science when it expanded how this medication could be dispensed and that the Supreme Court should follow suit,” lead study author Dr Ushma Upadhyay told Healthline.

However, a careful reading of the study suggests that its conclusions are not as positive as headlines have suggested. Of the 6,034 telehealth abortions, there was no follow-up with 1,421 women, about a quarter of them. The New York Times listed some of the negative outcomes:

Of the remaining patients, 85 needed additional measures to complete the abortion, usually with additional medication or a suction procedure in a medical facility.

Eighty-one patients visited emergency departments, and 15 patients had serious complications. Ten patients were hospitalized. Six received blood transfusions, two were treated for infections and one had surgery for an ectopic pregnancy.

Six patients turned out to have ectopic pregnancies, which would have made them ineligible for the pills. Studies show that ectopic pregnancies cannot always be identified early, even by ultrasound.

Tessa Longbons Cox, of the Charlotte Lozier Institute, a pro-life think tank, commented:

With a 74% follow-up rate, we don’t know what happened to a quarter of the women in the study. We know that the women who feel the most negative reactions following their abortions are least likely to participate in follow ups, and FDA data shows that women who have been harmed by abortion frequently end up seeking care from another doctor. Those missing voices are a crucial piece to the clinical puzzle as we can’t assume that those women had a positive outcome.

One of her colleagues, Dr Ingrid Skop, a Texas gynaecologist, said that the criteria for “adverse outcomes” in the UCSF study were too restrictive. They did not include emergency surgery to remove dead tissue, heavy bleeding for six to eight weeks, or intrauterine infections. “It’s extraordinary to see these serious complications dismissed and considered not worthy of discussion, when I know these women felt otherwise,” she observed.