According to a recent research in The Lancet, medical abortions may be performed safely and successfully through telehealth without a standard ultrasound scan. The study, a cooperation between researchers at the University of Cape Town in South Africa and the Karolinska Institutet in Sweden, underlines the prospects to offer secure and efficient abortion services in limited-resource settings.
The World Health Organization (WHO) estimates that 25 million unsafe abortions are carried out annually, and that as many as 47,000 women and girls die as a consequence. Limited resources, the shame associated with abortion, and tight abortion legislation are among the factors that lead women to seek unsafe abortion services. According to estimates, around 50 percent of all abortions in South Africa are carried out outside of the country’s general healthcare system, endangering the wellbeing of vulnerable women.
Participants of the study consisted of 900 women who were at least 9 weeks pregnany and had previously sought abortion services. They came from four clinics in Cape Town, South Africa. In-person consultations, ultrasounds, and oral medication procedures were all part of the standard of treatment for half the patients. The other half received care via telehealth, which involved the woman completing an online form for a consultation, receiving information and directions for the procedure via text messages, and taking both abortion medicines at home. A straightforward uterine inspection, which was carried out in the clinic as a safety measure, was the only in-person aspect the telehealth group received. The researchers subsequently examined the frequency of successful abortions, subsequent pregnancies, adverse outcomes, and treatment satisfaction. They discovered that the women who underwent telehealth-assisted abortions followed instructions precisely, obtained treatment outcomes that were just as effective as those of women who received conventional care, and did so while retaining similar levels of safety.
“What was interesting was that the majority of women in both groups expressed that they preferred the telemedicine option. This care model can be particularly important in resource-poor areas where there is a lack of healthcare infrastructure or restrictive abortion laws. For example, women can be examined at a clinic that does not have access to ultrasound and then receive guidance for the abortion remotely”, says Margit Endler, researcher at the Department of Women’s and Children’s Health at Karolinska Institutet.