Abortion medication is as safe over telehealth as in a doctor’s office

Abortion pills are as safe and effective when obtained through telehealth services and self-administered as they are when used in doctors’ offices, according to the largest study of telehealth abortions to date.

Prior studies of a few hundred pregnancies have shown telehealth abortions are safe. To investigate further with a larger sample size, Ushma Upadhyay at the University of California, San Francisco, and her colleagues collected data on more than 6000 telehealth abortions across 20 US states and Washington DC. All participants were less than 10 weeks pregnant. About 72 per cent of them obtained abortion pills through secure text messaging and the rest had appointments through video calls.

The researchers followed up with participants between three and seven days after their abortion, and again two to four weeks later. The team found that almost 98 per cent of the abortions effectively ended the pregnancy. Additionally, only 0.25 per cent of participants experienced serious side effects like uncontrollable bleeding or infection. By comparison, in-person use of mifepristone is more than 97 per cent effective and leads to adverse events 0.3 per cent of the time.

Abortion access is a contentious political issue in the US. In 2021, the US Food and Drug Administration (FDA) dropped in-person dispensing requirements for the abortion medication mifepristone, allowing people to get the pill through telehealth services and the mail. Anti-abortion groups are now challenging this decision in the US Supreme Court.

“These findings are consistent with the bounty of evidence that we have that mifepristone is safe and effective, and that the FDA’s decision to remove the in-person dispensing requirement was scientifically sound,” says Upadhyay.

“The outcomes are basically indistinguishable between telehealth and patients coming into a brick-and-mortar clinic,” says Samuel Dickman at reproductive health non-profit Planned Parenthood of Montana. Telehealth abortions are critical for providing care to people in rural areas or those who may not feel safe travelling to an abortion clinic due to abusive partners, he says.