Tele-medicine is a growing industry. The COVID-19 pandemic has moved what used to be many “in-person” events, including medical appointments, to an on-line format.
The pros are obvious: no risk of inadvertent infection of providers or patients, convenience, no need to travel, and sometimes there is reduced cost of appointments due to lessened overhead.
Abortion providers, like many clinicians, have embraced the telehealth format. We hear the PROs, but what about the short fallings and risks of this format with women seeking 1st trimester abortion?
While this is approved in some states, many states have reservations, so studies are being undertaken all over the U.S. to look at outcomes. One such study will start in November at the University of California San Francisco. The study is called The California Home Abortion by Telehealth (CHAT) Study (CHAT).
The description below is from the CHAT Study website:
- University of California, San Francisco plans to begin a study on telemedicine abortion. The study is not yet accepting applicants, but plans to in November 2020. Other abortion providers in the United States are also looking into and developing protocols for telemedicine abortion.
- This study aims to assess efficacy and safety outcomes of a model of abortion care implemented in response to the COVID-19 pandemic. The study involves telehealth for counseling and information, to maintain social distancing, but requires participants to pick up their medications in the clinic in keeping with the Food and Drug Administration’s (FDA’s) Risk Evaluation and Mitigation Strategy (REMS) requirements. The study will compare efficacy of this model to usual in-clinic care based on published rates. It will also investigate participant acceptability and feasibility of this model of care.
- Participants will complete an online medical screening form and watch videos about the study.
- Within 24 hours, the study clinician will conduct a face-to-face video-chat with the participant, review their medical history, and ensure they understand the study requirements, risks and benefits and provide additional information and counseling.
- The participant will then be directed to pick up their medication abortion pills from a study clinic. The participant will have 3 follow-up online check-ins or surveys: the first follow-up will be 3 days after the package is received, the second follow-up will be 7 days after the participant takes mifepristone, and third and final follow-up will be 4 weeks after the mifepristone.
What are the drawbacks of telemedicine abortion?
- Without an in-person visit, an ultrasound to confirm pregnancy dating cannot be done.
- It is not completely “travel-free” or “contact-free”. Trips to labs may be deemed necessary. Trips to radiology for ultrasound may be deemed necessary. Trips to pick up medications are necessary.
- Advocacy to discuss and assist with situations that may make an individual feel abortion is their only option are not always provided because the focus is on ending the pregnancy. Help to find housing, help with pre-existing addictions, help with finding shelter from domestic violence, resource assistance for those with financial difficulties, and baby material supplies are not delivered in a video chat visit with a medical provider.
- No physical exam is conducted. Without a physical exam, there is an important element of good care that is bypassed.
- Although complications are rare, when complications do occur, how will they be managed?
- Follow up visits, may be handled as on-line surveys and not as a video visits with a clinician. In a survey, questions and answers are not easily addressed.
- If a patient’s technology (phone, internet, etc.) fails, or they lose access, how are interactions to take place?
Before considering telemedicine abortion, call or text Sacramento Life Center.
Sacramento Life Center does NOT provide telemedicine abortion or emergency birth control, but can offered a face-to-face appointment with appropriate PPE for your safety, to discuss ALL of your options and answer ALL of your questions. Our focus is always on compassionate, quality health care.
We understand the merits of telehealth, but we feel this is a situation where women are better served when they have options other than telehealth. It’s like comparing a drive through to a sit-down dining experience.
If you have questions, or are considering online abortion appointments and online abortion pills, talk to us FIRST!
Image from : @Racool_studio