Study: Telehealth Equally Safe as Clinic Visits for Abortion Pills

Medication abortion can be delivered safely and effectively through telemedicine, according to new research from UC San Francisco that comes as the U.S. Supreme Court is about to hear a case that could severely restrict access to one of the two pills that are used to induce abortions.

Researchers analyzed data from more than 6,000 patients who obtained abortion pills from virtual clinics in 20 states and Washington D.C. between April of 2021 and January of 2022. They found there were no serious adverse events 99.8% of the time, and that abortions did not require follow-up care 98% of the time. This is similar to what has been found for patients who receive medication abortion at clinics or doctor’s offices.

The findings appear Feb. 15, 2024, in Nature Medicine.

Medication abortion, which now accounts for more than half of all abortions, involves taking two pills – mifepristone followed by misoprostol – and extensive research supports its safety and efficacy. Demand for the pills has increased since more than two dozen states banned or restricted abortion following the June 2022 decision by the Supreme Court to overturn Roe v. Wade, which guaranteed a constitutional right to abortion.

On March 26, the Supreme Court is scheduled to hear arguments over whether the U.S. Food and Drug Administration (FDA), which approved mifepristone in 2000, should roll back rules that in recent years have made the medication more widely available. In 2021, the agency removed the in-person dispensing requirement, allowing health care providers to have abortion pills sent through the mail after an online consultation. Telehealth abortion now accounts for nearly 10% of all U.S. abortions.

“This research confirms that the FDA followed science in allowing patients to get medication abortion through telehealth and the mail,” said the study’s first author, Ushma Upadhyay, PhD, MPH, a public health scientist with Advancing New Standards in Reproductive Health (ANSIRH) at UCSF. “Our findings make it abundantly clear that the case at the Supreme Court is simply an attempt to restrict access to abortion care, even in those states where it’s legal.”