20 May Can Telemedicine Enable Women To Safely Manage Their Own Abortions?
MedicalResearch.com Interview with:
Abigail R.A. Aiken, MD, MPH, PhD
LBJ School of Public Affairs
Population Research Center
University of Texas at Austin
Austin, TX, 78713
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We’ve known for some time that women in Ireland and Northern Ireland self-source their own abortions using online telemedicine. In fact, this model has revolutionized abortion access for Irish women. Yet very little was previously known about the outcomes of those abortions. How safe and effective are they? We wanted to address that knowledge gap with this study.
What this research shows is that self-sourced medication abortion, conducted entirely outside the formal healthcare setting, can have high rates of effectiveness and low rates of adverse outcomes. Women can successfully manage their own abortions and recognize the symptoms of potential complications. Among the small number who experienced such a symptom, virtually all sought in-person medical attention as advised.
MedicalResearch.com: What should readers take away from your report?
Response: When most people think about self-sourced or self-induced abortion, they tend to think about coat hangers or tables in back alleys. But these findings show that in 2017, self-sourced abortion can involve a network of people helping and supporting each other through a safe and effective process in their own homes. That’s a huge step forward for public health.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should examine the outcomes and acceptability of online telemedicine and other models of abortion provision in different settings. Demographic, cultural, and policy differences across contexts may all play a role in rates of care seeking and in women’s experiences.
MedicalResearch.com: Is there anything else you would like to add?
Response: One of the most common concerns about abortion using online telemedicine in settings where abortion is restricted is that women might inaccurately report their medical history or gestational age. This model of telemedicine trusts women to accurately self-report, and the results of the study support this move towards a more autonomous model of care.
Abortion laws in Northern Ireland date back to Victorian times, governed by the 1861 Offenses Against the Person Act. In the last few years, women have been prosecuted for doing their own abortions at home through online telemedicine. Under the law, women are being punished for using “poisons” or “noxious substances” to end their pregnancies. But this study adds to the weight of evidence that, far from using “poisons”, women who self-source their own abortions using online telemedicine are using the same medications provided in the clinical setting to avail of a highly effective and safe healthcare service.
Our disclosures are listed in the main paper on the BMJ website: http://www.bmj.com/content/357/bmj.j2011
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Self reported outcomes and adverse events after medical abortion through online telemedicine: population based study in the Republic of Ireland and Northern Ireland
BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2011 (Published 16 May 2017)Cite this as: BMJ 2017;357:j2011
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