United States: A new study has shown that taking abortion pills via telemedicine with mail delivery – a method used by more and more patients in need of abortion – is completely as safe and effective as abortion pills being obtained in person by a doctor.
The trial medication proved to be almost 98 percent effective and remained safe for 99 percent of people who had taken it, according to the study.
About the study
The research, conducted by the University of California- San Francisco (UCSF) researchers, examined more than 6,000 patients‘ experiences over the course of a few months, that began in April of 2021, when the federal government started permitting abortion pills to be delivered via the mails, and lasted until January of 2022.
The patients use one of three telemedicine abortion organizations — Hey Jane, Abortion on Demand, or Choix – accessed in 20 states and Washington, D.C.
The research, published on Thursday in Nature Medicine, ended five months before the Supreme Court overturned Roe v. Wade, which paved the way for an energetic wave of state abortion bans and restrictions.
Since then, more telemedicine services have been found and become widely used among patients who utilize the opportunities provided by the method offering convenience, privacy, and affordability more than visiting clinics or doctors, if it requires travel to another state.
The services in the study offered pills to pregnant women who were ten weeks along (another service that offered an eight-week limit) and did a medical screening of patients that would make them ineligible, like ectopic pregnancies or blood coagulation problems, the New York Times report.
Doctors, nurse practitioners, physician assistants, and midwives of the service in most cases were able to determine patient eligibility from their observations about pregnancy and their health as well as from the written or oral information without the need for ultrasound examinations, which are very difficult logistically to some patients.
If a sonogram was not able to shed light on a patient’s medical history, those patients were advised to get a sonogram done – 486 did and the latter comprised around 8 percent of 6,034 patients, who received pills in a particular study.
Results of the study
Researchers looked through patients’ records and were able to find out who had abortions among the patients serving in the services, which totaled about three-fourths, or 4,454, of the women.
A vast majority — 4,351 patients, or 97.7 percent — completed abortions with the standard regimen: during the first days of medical abortion, a patient takes mifepristone, which stops the pregnancy’s further development, and misoprostol, which contracts the uterus and makes it possible to expel the tissue from the body, a day or two later, the New York Times report.
Afterward, among 85 patients, additional steps were applied, generally including medication or the suction procedure in a medical facility.
Eighty-one patients visited the emergency departments and there were fifteen patients with grave consequences, according to the study. Ten patients were hospitalized. Six became transfusion patients, two were getting infection treatment, and one was under surgery for ectopic pregnancy.
Further investigation shows that six of the patients have ectopic pregnancies, which means that they would have been barred from the pills if the truth had been known.
Research has revealed that conducting ectopic pregnancy examinations with the help of ultrasound still remains problematic almost in every case.
According to the data, 38 percent of the patients who came to the emergency rooms did not require admittance, the New York Times reports.
Dr. Ushma Upadhyay, a public health scientist at U.C.S.F. and one of the study’s authors said that when patients seldom visit in emergency department “they don’t know whether what they’re experiencing is normal and they sometimes don’t have anyone to ask and they don’t want to tell a lot of people about their abortion,” reported the New York Times.
None of the patients we examined were in excess of 10 weeks of pregnancy.
The effectiveness and safety rates were similar to the other large studies undertaken in person medication abortion and also similar to that undertaken in telemedicine abortion in which an ultrasound is mandatory.
The two dosing regiments were both akin to the rate marked on the label from the Food and Drug Administration (FDA) for Mifepristone, the New York Times report.
Other researchers also found the safety and efficacy difference between real-time video consultations and a prescription given based on a patient’s written text information, which is predominantly the latter, negligible.
The study found that two patients inquired about “abortion pill reversal,” which is a nonscientific claim that abortions can be terminated after taking the first drug. Both were informed that “evidence-based reversal treatment does not exist” and were directed to urgent in-person care.
What are the larger implications of the new approach?
A lawsuit has been filed against the FDA by abortion opponents who are attempting to limit mifepristone. The claims of one of the plaintiffs are that abortion pills are harmful.
FDA supported its view with strong scientific evidence that the pills are safe, and the studies that abortion opponents used to support their position were recently retracted by a publisher of a scientific journal, the New York Times reports.
In August, an appeals court ruled to keep mifepristone legal but imposed tight restrictions that would render its mailing or telemedicine prescription impossible.
Arguments in the case will be heard by the Supreme Court next month. The advocates for the continued availability of telemedicine abortion may bring up the new study findings.