Abstract
Background
In states requiring physicians to dispense mifepristone, the small number of providers
offering the method limits its uptake. In 2008, Planned Parenthood of the Heartland
in Iowa began providing medical abortion via telemedicine at clinics without an on-site
physician. The purpose of this study was to evaluate patients' and providers' experiences
with telemedicine provision of medical abortion.
Methods
Between October 2009 and February 2010, in-depth interviews were conducted at Planned
Parenthood clinics with 25 women receiving medical abortion services (20 telemedicine
patients and 5 in-person patients) and 15 clinic staff. Data were analyzed qualitatively
for themes related to acceptability of the telemedicine service delivery model.
Findings
Patients and providers cited numerous advantages of telemedicine, including decreased
travel for patients and physicians and greater availability of locations and appointment
times compared with in-person provision. Overall, patients were positive or indifferent
about having the conversation with the doctor take place via telemedicine, with most
reporting it felt private/secure and in some cases even more comfortable than an in-person
visit. However, other women preferred being in the same room with the physician, highlighting
the importance of informing women about their options so they can choose their preferred
service modality.
Conclusions
The findings from this study indicate that telemedicine can be used to provide medical
abortion in a manner that is highly acceptable to patients and providers with minimal
impact on the clinic.
Practice Implications
This information demonstrates the feasibility of telemedicine to extend the reach
of physicians and improve abortion access in rural settings.
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Biography
Kate Grindlay, MSPH, is a Senior Project Manager at Ibis Reproductive Health. Her current work focuses on research to expand the availability and accessibility of reproductive health services for women in the U.S. and internationally.
Biography
Kathleen Lane, CN, is a consultant at Provide with expertise in reproductive health and field work using qualitative methods.
Biography
Daniel Grossman, MD, is the Vice President for Research at Ibis Reproductive Health, an Assistant Clinical Professor at UCSF, and a practicing physician. His current work focuses on improving access to contraception, safe abortion, and HIV services.
Article info
Publication history
Published online: February 14, 2013
Accepted:
December 6,
2012
Received in revised form:
December 4,
2012
Received:
August 22,
2012
Identification
Copyright
© 2013 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
