Implementation of telemedicine preoperative visits for abortion procedures through 18 weeks gestation at a Northern California hospital-based center

Matulich, Melissa C.; Hou, Melody Y.; Chen, Melissa J.; Uhm, Suji; Creinin, Mitchell D.

doi:10.1016/j.contraception.2022.06.001

Cited by 4 publications

(16 citation statements)

References 23 publications

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“…The included studies were published between 2011 and 2022 and described a range of experiences, strategies, and interventions on the use of telehealth for providing medication abortion services 20–44 . Most used cohort designs (n = 16), although cross‐sectional (n = 5), mixed‐methods (n = 2), prevalence (n = 1), and quasiexperimental (n = 1) studies were also represented.…”

Section: Resultsmentioning

confidence: 99%

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The Provision of Abortion Care via Telehealth in the United States: A Rapid Review

Brown,

Neerland,

Weinfurter

et al. 2023

J Midwife Womens Health

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IntroductionThe recent Supreme Court decision Dobbs v. Jackson Women's Health that has overruled Roe v. Wade has resulted in severe limitations of abortion access throughout the United States. Telehealth has been put forth as one solution for improving access for reproductive health care, including abortion services. Telehealth has demonstrated safety and efficacy in several health care disciplines; however, its use for abortion care and services has not been explored and synthesized.MethodsAs part of a larger review on telehealth and general reproductive health, our team identified a moderate amount of literature on telehealth and abortion care. We conducted a rapid review searching for eligible studies in MEDLINE, Embase, and CINAHL. Information was extracted from each included study to explore 4 key areas of inquiry: (1) clinical effectiveness, (2) patient and provider experiences, (3) barriers and facilitators, and (4) the impact of the coronavirus disease 2019 (COVID‐19) pandemic.ResultsTwenty‐five studies on the use of telehealth for providing abortion services published between 2011 and 2022 were included. Telehealth for medical abortion increased during the COVID‐19 pandemic and was found to be safe and clinically effective, with high patient satisfaction. Overall, telehealth improved access and removed barriers for patients including lack of transportation. Legal restrictions in certain states were cited as the primary barriers. Studies contained limited information on the perspectives and experiences of health care providers and diverse patient populations.DiscussionAbortion care via telehealth is safe and effective with high satisfaction and may also remove barriers to care including transportation and fear. Removing restrictions on telehealth for the provision of abortion services may further improve access to care and promote greater health equity.

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Section: Resultsmentioning

confidence: 99%

“…We identified 11 studies that investigated barriers and facilitators of telehealth for abortion services 21,22,24,28,30,32,34,35,37–39 . Telehealth facilitated access to abortion services and removed barriers for patients.…”

Section: Resultsmentioning

confidence: 99%

The Provision of Abortion Care via Telehealth in the United States: A Rapid Review

Brown,

Neerland,

Weinfurter

et al. 2023

J Midwife Womens Health

View full text Add to dashboard Cite

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“…Also constrained are those who do not know where to obtain an ultrasound or lack insurance or resources required for a separate ultrasound visit in addition to out-of-state travel for abortion care. These obstacles may underpin why in a pilot telemedicine program among patients 12–18 weeks’ gestation, which required a local ultrasound to determine gestational duration prior to the remote preoperative appointment, lack of adequate ultrasound documentation was the largest contributing factor for study ineligibility (45% or 89 out of 200 study participants) [20 ▪ ].…”

Section: Considerations For Clinical Practicementioning

confidence: 99%

“…Obtaining a preoperative ultrasound among patients with a history of cesarean delivery prior to travel for abortion may facilitate coordination of and preparation for care. However, as previously mentioned, individual patients may face barriers to obtaining this ultrasound [20 ▪ ].…”

Section: Considerations For Clinical Practicementioning

confidence: 99%

“…In settings where procedural abortions are preceded by an appointment and pharmacologic-only cervical preparation, a telemedicine visit and arranging for medications to be mailed or sent to a pharmacy near the patient could spare the patient a visit and reduce the associated burden. A recent pilot study implementing this telemedicine preoperative visit strategy for procedural abortion patients with a gestation of 12–18 weeks found high patient satisfaction among those who qualified and were interested in the option [20 ▪ ]. Many patients were not eligible, as the protocol required them to have no medically significant health issues, video connectivity, and an adequate ultrasound.…”

Section: Considerations For Clinical Practicementioning

confidence: 99%

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Travel for abortion care: implications for clinical practice

Lerma,

Coplon,

Goyal

2023

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of review Traveling long distances to obtain abortion care due to restrictions and scarce availability is associated with significant obstacles. We review clinical strategies that can facilitate abortion access and outline considerations to ensure person-centered and equitable care. Recent findings Establishing a patient's gestational duration prior to travel may be beneficial to ensure they are eligible for their desired abortion method at the preferred facility or to determine if a multiday procedure is required. If a local ultrasound cannot be obtained prior to travel, evidence demonstrates people can generally estimate their gestational duration accurately. If unable to provide care, clinicians should make timely referrals for abortion. Integration of telemedicine into abortion care is safe and well regarded by patients and should be implemented into service delivery where possible to reduce obstacles to care. Routine in-person follow-up care is not necessary. However, for those who want reassurance, formalized pathways to care should be established to ensure people have access to care in their community. To further minimize travel-related burdens, facilities should routinely offer information about funding and practical support, emotional support, and legal resources. Summary There are many opportunities to optimize clinical practice to support those traveling for abortion care.

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Telemedicine Abortion

Dunlop,

Sinay,

Kerestes

2023

Clinical Obstetrics &Amp; Gynecology

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Telemedicine has become a substantial part of abortion care in recent years. In this review, we discuss the history and regulatory landscape of telemedicine for medication abortion in the United States, different models of care for telemedicine, and the safety and effectiveness of medication abortion via telemedicine, including using history-based screening protocols for medication abortion without ultrasound. We also explore the acceptability of telemedicine for patients and their perspectives on its benefits, as well as the use of telemedicine for other parts of abortion care. Telemedicine has expanded access to abortion for many, although there remain limitations to its implementation.

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Implementation of telemedicine preoperative visits for abortion procedures through 18 weeks gestation at a Northern California hospital-based center

Cited by 4 publications

References 23 publications

The Provision of Abortion Care via Telehealth in the United States: A Rapid Review

The Provision of Abortion Care via Telehealth in the United States: A Rapid Review

Travel for abortion care: implications for clinical practice

Telemedicine Abortion

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