Medication Abortion Using Telehealth Is As Safe As In-Person Care, Study Finds

By Joanna Thompson

The combination of mifepristone and misoprostol, the two-drug regimen that is usually prescribed to terminate a pregnancy, is extremely safe and effective — even when the medication abortion is provided over a remote telehealth connection, a new study shows. In a survey of more than 6,000 remote medication abortions between April 2021 and January 2022, only 0.25 percent of patients experienced adverse outcomes such as excessive bleeding or infection. Less than 2.5 percent experienced a continued pregnancy. Published on February 15 in Nature Medicine, the study research is the largest study of at-home telehealth abortion to date.

“The study finds that providing telehealth care is just as safe and effective as providing abortion care in person,” says Ushma Upadhyay, a quantitative public health scientist at the University of California, San Francisco, and the paper’s lead author. In addition to synchronous abortion care, in which a patient communicated with a health professional over the phone or a video chat, Upadhyay’s team evaluated asynchronous care, in which the patient and provider did not interact in real time. The researchers found that both approaches had equally successful outcomes.

“Providing the option of asynchronous care really helps improve access,” says Kelly Cleland, executive director of the American Society for Emergency Contraception, who was not involved in the study. For example, receiving abortion care via secure text messaging might be the best option for people who live in a rural area with limited Wi-Fi access or who could face threats of violence from intimate partners. The new study supports this as a safe and effective option, Cleland says.

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