Remote Options for Medication Abortion: Improving Patient Care During and After the Covid-19 Crisis

Abstract

The COVID-19 pandemic has shifted primary care and other practices towards remote care and telemedicine options to minimize viral exposure. Although in-person visits are sometimes indispensable, research shows that telemedicine can expand access to vital services without sacrificing patient-centered care.

Medication abortion is an essential, time-sensitive service that is particularly well-suited to telemedicine provision, including in primary care settings. Decades of clinical research and practice guidelines from core medical societies affirm the safety and efficacy of providing medication abortion remotely. Neither FDA nor professional guidelines require sonography for medication abortion, and research shows that necessary clinical assessments can be achieved without ultrasound. New practice guidelines recommend against Rh testing for abortions under 8 weeks of pregnancy and rely on patient history for those provided from 8 to 11 weeks.

As primary care providers, we can and should provide high-quality, low-risk abortion care for patients without point-of-care exams and labs. This discussion includes a detailed checklist for providing such remote-care medication abortion in a variety of settings. Such strategies will allow more clinicians to offer this essential care both during and after the Covid-19 crisis.