Here's what you need to know about at-home medical abortions.
Abortion is understandably a hot topic in the United States right now, with passionate people on both sides of the argument making their cases. While some have moral qualms with the concept of abortion, from a medical perspective, early medical abortion—which is usually performed up to nine weeks after conception and administered by a series of two pills (mifepristone and misoprotol)—is generally thought of as a safe procedure. That's because in a clinic setting, having a serious complication from a medical abortion is incredibly rare, and is actually 14 times safer than childbirth.
Not much was previously known, though, about the relative safety of at-home medical abortions that were obtained virtually through telemedicine. This type of abortion is really the only option for women in countries where the procedure is restricted (aside from traveling to another country). New research published in BMJ suggests that at-home early medical abortions that are done with help from physicians remotely are just as safe as in-clinic ones. (Here, find out why more women are searching for DIY abortions.)
Here's how the study worked. Researchers looked at self-reported data from 1,000 women in Ireland and Northern Ireland who underwent early medical abortions via telemedicine. The data for the study was provided by Women on Web, an organization based in the Netherlands that helps women obtain early at-home medical abortions if they live in countries where abortion laws are highly restrictive. The service works by matching up women who need abortions with doctors who provide them with medication after the women answer a questionnaire about their situation. Throughout the process, they receive online help and are advised to seek local medical attention if they experience complications or unusual symptoms.
Of the 1,000 women who were evaluated, 94.5 percent successfully induced an abortion at home. A small number of women experienced complications. Seven women reported receiving a blood transfusion, and 26 women reported receiving antibiotics after the procedure. Overall, 93 women were advised by WoW to seek medical attention outside of the service. No deaths were reported by friends, family, or the media. That means that less than 10 percent of these women needed to see a doctor in person at all, and less than 1 percent had serious complications. (FYI, this is why abortion rates are the lowest they've been since Roe v. Wade.)
From this, the authors determined that the safety of self-sourced early medical abortions is comparable with that of in-clinic ones. Plus, there are advantages to having a virtual option. "Some women may prefer abortion using online telemedicine because they can use the medications in the comfort of their own homes, or they may benefit from the privacy telemedicine offers if they cannot easily access a clinic due to a controlling partner or family disapproval," explains Abigail R.A. Aiken, M.D., M.P.H., Ph.D., lead author of the study, an assistant professor and faculty associate at LBJ School of Public Affairs at the University of Texas at Austin. (To hear more about how abortion affects real women, read how one woman shared her unique struggle to love her postpartum body after an abortion.)
Considering that Planned Parenthood was just forced to close several of its locations in Iowa and it's not exactly easy to get an abortion if you need one in other states due to state-mandated restrictions, telemedicine could play a role in abortion access in the U.S. too. But there's one problem: Services like WoW are generally not available here in the U.S., due to laws in many states requiring that the administering physician be present at the time of the abortion.
"The main difference is that women in Ireland have access to a service that ensures they can do their own abortions safely and effectively by providing accurate information, a trusted source of medications, and advice and support before, during, and after the abortion," Dr. Aiken explains. "Future conversations about abortion access in the U.S. should include telemedicine models as a way of improving both public health and reproductive rights."