Early Medical Abortion, Equality of Access, and the Telemedical Imperative

Abstract

Telemedicine has recently become a key focus of healthcare systems globally, heavily influenced by the COVID-19 pandemic. Implementing telemedicine can bring myriad benefits for both patients (improved access and enhanced autonomy) and providers (improved service efficiency). One area in which telemedicine might have a huge impact is in improving access is abortion care. Telemedical early medical abortion encompasses a wide range of services, but fundamentally it involves remote provision of some or all aspects of the care pathway (confirmation of pregnancy/gestational age, consultation/counselling, provision of medications, and aftercare). We examine the safety, effectiveness, and acceptability of early medical abortion provided by telemedicine, alongside the access barriers created by the law in the UK and US. In doing so, we argue that there is a moral imperative to make the necessary regulatory changes to enable the provision of telemedical early medical abortion. In both the U K and US, abortion is heavily regulated—exceptionally so when compared to other routine healthcare. This law has had the effect of exacerbating the social circumstances and geography that can make access to abortion clinics difficult. Telemedicine might go some way to addressing these issues, but much regulation of abortion in these jurisdictions continues to limit the establishment of telemedical early medical abortion services. Whilst we focus on the legal and policy landscape in the UK and US, the case we advance in support of the telemedical provision of early medical abortion is broadly applicable.