Many women searching for a way to terminate an unwanted pregnancy are encountering obstacles that make it all but impossible to obtain such services through normal health care settings. In some countries, abortions are prohibited except in a few restricted circumstances. However, help is available to those in need. Recent research indicates that telemedicine offers a safe and effective method to end a pregnancy.
A study published in the May 16, 2017, issue of “The BMJ” (originally known as the British Medical Journal), documents the experiences of more than 1,000 women who underwent medical abortions under telemedicine guidance. The telemedicine provider in all the cases covered by this study was WomenonWeb.org, an Amsterdam-based nonprofit. WoW describes itself as “a digital community of women who have had abortions, medical doctors, researchers, and individuals and organizations that support abortion rights.
Medical vs. Surgical Abortion
Unlike surgical abortion, which is performed by a doctor in a clinical setting and requires anesthesia, medical abortion is induced by one or more prescription medications that cause the expulsion of the pregnancy from the uterus. It can be self-induced in the privacy of one’s home, providing that home is located within easy reach of emergency medical care in the unlikely event of complications.
For women who are less than 10 weeks pregnant, have no serious illnesses, and live in a country with little or no access to abortion, WoW provides referrals to cooperating physicians who prescribe abortion-inducing medications. Those medications are mifepristone (also known as RU-486) and misoprostol, which is also available under the brand name Cytotec.
Irish Women Subjects of Study
The study published in “The BMJ” tracked WoW-facilitated abortions among women living in Northern Ireland and the Republic of Ireland, both of which severely restrict access to abortion services. During a period from 2010 to 2012, abortion drugs were prescribed for 1,636 women, 1,158 of whom requested follow-up information from WoW.
A total of 1,023 women confirmed use of the medications, and 1,000 of those provided follow-up information to WoW. Of those 1,000 women, 781 were less than seven weeks pregnant and 219 were somewhere between seven and nine weeks pregnant. Overall, 94.7 percent of all these women reported that they had successfully terminated their pregnancies without resort to surgical intervention. Seven women required blood transfusions, and another 26 women required antibiotics in the wake of their medical abortions. In all, 93 women experienced symptoms for which in-person medical attention was recommended, and all but five of these sought medical attention.
Many Lack Abortion Access
The study was conducted by U.S., U.K., and Moldovan researchers in collaboration with two representatives from Women on Web International Foundation. The authors of the study point out that roughly 25 percent of the world’s population lives in countries with highly restrictive abortion laws. Consequently, women in these countries often resort to unsafe methods to end their pregnancies, leading an estimated 43,000 to die each year because they lack access to safe and legal abortion services.
Women who turn to WoW for abortion services are first asked to take a pregnancy test and, if possible, an ultrasound. Each patient is then required to complete a 25-question online consultation that covers the patient’s medical history and the circumstances and status of her pregnancy.
Contributions Requested
To help defray the costs of their telemedicine abortion services, WoW asks that women whom they help to make a contribution of at least 70 to 90 Euros (US$78.29 to US$100.66 as of May 27, 2017), depending on the country in which they live and their financial circumstances. Exceptions can be made for women who are in dire straits financially.
Women whose medical history and pregnancy status make them appropriate candidates for medical abortion are then prescribed the abortion-inducing medications, which are mailed to them by a partner organization. Along with the medications, abortion candidates receive real-time instructions on their use. WoW’s multilingual help desk, staffed by trained counselors, stands ready to offer further guidance before, during, and after the abortion process.
Online Evaluation by Patient
To track the outcomes of their telemedicine-facilitated abortions, WoW asks women who use their services to complete an online evaluation of these services four weeks after the medical abortion was performed. Alternatively, they can communicate their experiences directly to WoW’s help desk by email.
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