Distance from clinic may influence abortion pill access- study

Women who live farther from a medical clinic and those who identify as multiracial are more likely to use telemedicine to get abortion pills, researchers at the University of Washington have found.

The study, published in JAMA Network Open, analysed medical records of patients who visited the Cedar River Clinic system in Tacoma and Seattle between April 2020 and January 2022.

Of the 1,241 patients, included in the study 69 per cent received an in-clinic appointment and 31 per cent scheduled a telehealth visit and received their medications either through the mail or picked them up at a clinic location.

Women who identified as multiracial or “other” race were four and a half times more likely to access the clinic’s telehealth services than white women, the study showed.

Researchers found black women were more likely to seek care in clinic. Women who were younger, who were non-English speakers, and who had at least one health issue were also more likely to receive care in person.

“One of the main takeaways,” said lead author Anna Fiastro, a family medicine research scientist at UW Medicine, “is that the further patients are from a brick-and-mortar clinic, the more likely they are to use telehealth to access medication abortion.”

Of the 232 study participants who self-identified as black, only 46 received telehealth visits, while over 80 per cent had in-clinic visits.

The more limited use of telehealth for abortion care by black women may track with documented distrust of the medical system, given past abuses and racial inequities documented across healthcare, Fiastro said.

Seattle also has a growing number of sub-Saharan African immigrants who may identify as black. This population may perceive in-clinic services as more private, especially if abortion is highly stigmatised in their communities, the paper’s senior author Dr Emily Godfrey, professor of family medicine and of obstetrics and gynaecology, explained.

Godfrey suggested the relative reluctance of younger patients to use telehealth might indicate that population is “wary of telehealth’s legitimacy and whether getting care this way really works.”

Researchers said more must be done to ensure patients for whom English is not their primary language have access to technology and interpreters.

Godfrey and Fiastro said studies such as this are crucial to convey the importance of telehealth access to medication abortion pills, especially for patients in rural areas and underserved communities.

“Washington’s model could be a template for providing abortion medicines equitably in other states,” they added.