P052“I feel like i had the best team”: Patients’ experiences with telehealth abortion in primary care

Abstract

Objectives To explore patients’ experiences with telehealth abortion with medication delivery offered at a large Massachusetts safety-net primary care (PC) network. Methods This PC network cares for medically-underserved communities and was among the first to integrate telehealth abortion with medication delivery. We conducted semi-structured in-depth phone interviews from March to May 2022 with English-, Spanish-, or Portuguese-speaking patients who received telehealth abortion with medication delivery between July 28, 2020 and December 31, 2021 (n=55). Interviewers asked participants to walk through their experience of learning about the pregnancy, seeking and receiving care, and follow-up. The team employed frequent reflexivity, wrote memos post-interviews, and met frequently to discuss emergent patterns and themes. We employed inductive thematic analysis. Results We interviewed 14 participants (11 English, 1 Spanish, 2 Portuguese). Overall, participants reflected positively on their telehealth abortion experience within their PC network. They valued remote care access, familiarity and trust of the PC system and providers, privacy, and ease of scheduling and medication delivery. Telehealth empowered patients: They appreciated the ability to choose where to have the visit and described feeling reduced abortion-related stigma. Respondents described telehealth as a care modality that mitigated the provider-patient power dynamic and minimized in-clinic discomfort. Participants described feeling cared for, being treated with respect, and appreciation for receiving care from their established healthcare team within the context of ongoing social and medical health concerns. Conclusions Participants who receive telehealth abortion in their PC network with medication delivery report care as person-centered and empowering. Telehealth abortion is an acceptable alternative to in-clinic medication abortion. To explore patients’ experiences with telehealth abortion with medication delivery offered at a large Massachusetts safety-net primary care (PC) network. This PC network cares for medically-underserved communities and was among the first to integrate telehealth abortion with medication delivery. We conducted semi-structured in-depth phone interviews from March to May 2022 with English-, Spanish-, or Portuguese-speaking patients who received telehealth abortion with medication delivery between July 28, 2020 and December 31, 2021 (n=55). Interviewers asked participants to walk through their experience of learning about the pregnancy, seeking and receiving care, and follow-up. The team employed frequent reflexivity, wrote memos post-interviews, and met frequently to discuss emergent patterns and themes. We employed inductive thematic analysis. We interviewed 14 participants (11 English, 1 Spanish, 2 Portuguese). Overall, participants reflected positively on their telehealth abortion experience within their PC network. They valued remote care access, familiarity and trust of the PC system and providers, privacy, and ease of scheduling and medication delivery. Telehealth empowered patients: They appreciated the ability to choose where to have the visit and described feeling reduced abortion-related stigma. Respondents described telehealth as a care modality that mitigated the provider-patient power dynamic and minimized in-clinic discomfort. Participants described feeling cared for, being treated with respect, and appreciation for receiving care from their established healthcare team within the context of ongoing social and medical health concerns. Participants who receive telehealth abortion in their PC network with medication delivery report care as person-centered and empowering. Telehealth abortion is an acceptable alternative to in-clinic medication abortion.