Women's and Providers' Experiences with Medical Abortion Provided Through Telemedicine: A Qualitative Study

• Published in: Women's health issues Vol. 23; no. 2; pp. e117 - e122
• Main Authors: Grindlay, Kate, MSPH, Lane, Kathleen, CN, Grossman, Daniel, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2013
• Subjects: Abortion; Abortion, Induced - methods; Adolescent; Adult; Attitude of Health Personnel; Clinics; Doctors; Female; Health Services Accessibility; Humans; Interviews as Topic; Iowa; Medically Underserved Area; Obstetrics and Gynecology; Parenthood; Patient Acceptance of Health Care; Patient Preference; Patient Satisfaction; Pregnancy; Qualitative Research; Rural Health Services - organization & administration; Rural Population; Telemedicine; Telemedicine - utilization; Women; Young Adult; Iowa
• ISSN: 1049-3867; 1878-4321
• DOI: 10.1016/j.whi.2012.12.002

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.