Distance from clinic affects abortion pill access

According to a new study, women who live further away from a medical facility and those who identify as multiracial are more likely to use telemedicine to obtain abortion-pills">abortion pills rather than visiting a clinic.

The findings were published in JAMA Network Open.

“One of the main takeaways,” said lead author Anna Fiastro, a family medicine research scientist at UW Medicine, “is that the further patients are from a brick-and-mortar clinic, the more likely they are to use telehealth to access medication abortion.”

Fiastro is part of the division of family planning in the Department of Obstetrics and Gynecology.

According to Fiastro, the telemedicine option may also assist patients in reducing time away from family and work, as well as travel expenditures.

The medical records of individuals who visited the Cedar River Clinic system in Tacoma and Seattle between April 2020 and January 2022 were examined by the researchers. This clinic network was one of the first in the United States to provide telemedicine abortion services.

The study's 1,241 patients (average age 30 years) received an in-clinic appointment, whereas 383 planned a telehealth visit and received their drugs either by mail or in person at a clinic location.

Women who were classified as multiracial or "other" race were 4.5 times more likely than white women to use the clinic's telemedicine services. The researchers discovered that black women were more likely to seek care in a clinic. Women who were younger, non-English speakers, and had at least one health concern were also more likely to be seen in person at a clinic.

The study found three groups of patients who were more likely to acquire abortion-pills">abortion pills at a clinic: those in their early to mid-20s, those who had language problems (defining their primary language as a language other than English), and those who self-identified as Black or African American.

Only 46 of the 232 study participants who self-identified as Black had telehealth appointments, while more than 80 per cent received in-clinic visits. Given prior abuses and racial injustices reported across healthcare, Black women's usage of telehealth for abortion treatment may correlate with established scepticism of the medical system, according to Fiastro.

There is also an increasing number of Sub-Saharan African immigrants in Seattle who identify as Black.

According to the paper's principal author, Dr Emily Godfrey, professor of family medicine and obstetrics and gynaecology, this population may see in-clinic services as more private, especially if abortion is severely stigmatised in their community.

Younger patients' reluctance to use telehealth may reflect that the community is "wary of telehealth's legitimacy and whether getting care this way really works," Godfrey stated. In order to increase the use of telehealth among patients who do not speak English as their first language, the researchers concluded that more has to be done to ensure access to technology and interpreters.

According to Godfrey and Fiastro, research like this one is critical in communicating the value of telemedicine access to abortion-pills">abortion pills, especially when seeking to serve patients in rural and underserved settings.

“Washington’s model could be a template for providing abortion-medicines">abortion medicines equitably in other states,” said Fiastro.