Findings from a population-based study published in The BMJ suggest self-sourced medical abortion using online telemedicine “can be highly effective” with outcomes being more favorable than those seen in clinic protocols. 

A team of researchers aimed to asses self-reported outcomes and adverse events following self-sourced medical abortion via online telemedcine. The study was conducted in 1,000 women residing in the Republic of Ireland and Northern Ireland, where abortion is not available through the formal healthcare system “except in a few restricted circumstances.” The women sourced medical abortion through an online telemedicine service called Women on Web (WoW) between January 2, 2010 and December 31, 2012.

The main outcome measure was successful medical abortion, defined as the proportion of women who reported terminating their pregnancy without surgical intervention. Study authors also measured rates of adverse events such as receiving antibiotics and blood transfusion, and deaths. In addition, they assessed the frequency with which women reported experiencing symptoms of a potentially serious complication and the amount of women who sought medical attention.

Between 2010 and 2012, abortifacients mifepristone and misoprostol were sent to 1,0636 women; follow-up data was available for 1,158 women. Of these, 1,023 women reported use of the medications and follow-up data was available for 1,000 women. Seventy-eight percent of the women were <7 weeks pregnant and 22% were 7–9 weeks pregnant when they accessed WoW.  

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The data showed 94.7% of women were able to successfully terminate their pregnancy without surgical intervention. Seven women received a blood transfusion and 26 women received antibiotics. No deaths related to the intervention were reported.

Moreover, 87 of the 93 women advised to seek medical advice for their symptoms sought appropriate help. The five women who did not seek medical help did not report experiencing any adverse outcome.

Overall, study authors found that self-sourced medical abortion via an online telemedicine service could be highly effective. The rates of adverse events were low and women were able to identify any symptoms of complications. Findings from this study hold “important implications for women worldwide living in areas where access to abortion is restricted,” the authors noted.

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