An over-the-phone abortion service to end unwanted pregnancies in their early stages in Australia has been found to be safe, effective and convenient.
Australia became the first country where women can legally access abortion pills without having to see a medical professional in person in 2015. Instead, women can order the pills over the phone from a private provider, called the Tabbot Foundation.
A study of the first 1000 women who used the service shows that over 95 per cent had an abortion at home with no complications, and did not need to see a doctor afterwards. Over 97 per cent said they were highly satisfied with the service.
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Two-thirds of Tabbot鈥檚 clients were from rural areas, where abortions have traditionally been difficult to access.
鈥淚t means they don鈥檛 have to travel long distances or face possible judgement from the one doctor or pharmacist in their town,鈥� says Paul Hyland, the gynaecologist who set up the foundation.
But Hyland says the service may benefit women in urban areas too, because it means they can avoid any protestors outside abortion clinics. Tabbot currently provides abortions to about 50 women a week and the demand is steadily increasing, he says.
Pills by post
When a woman requests abortion pills, she is first called by a doctor from the Tabbot Foundation to rule out any medical conditions that might make the procedure unsafe. They also organise a blood test and ultrasound scan at a local provider to confirm she is less than nine weeks pregnant, because one of the drugs involved carries a higher risk of complications after this time.
Once the doctor gives the go-ahead, a package is mailed to the woman with the abortion drugs mifepristone and misoprostol, as well as painkillers, antibiotics and anti-nausea medication. A nurse calls her after the package has arrived to explain how to take the drugs and calls her a set number of hours afterwards to check she is OK. A 24-hour hotline provides additional support if needed.
The cost of the service is A$250, which is half that of the up-front cost of an equivalent abortion at a private bricks-and-mortar clinic in Australia.
Online market
鈥淚t is brilliant to see this service being offered to women in Australia,鈥� says at the British Pregnancy Advisory Service. 鈥淭his study confirms what we already know 鈥� home use of abortion medications with telemedical support to end an early pregnancy is safe, effective and appreciated by women.鈥�
In the UK and US, women must attend a clinic in person to obtain abortion drugs. This is difficult for those who live a long distance from a clinic, have work or childcare commitments, or need to maintain secrecy due to a challenging home environment, says Murphy.
As a result, many are illegally seeking abortion pills online. 鈥淲e know there is a demand for this type of service in the UK as a recent study found a significant number of women attempted to access medical abortions online instead of through the healthcare system due to access issues, including geographical problems,鈥� says Kate Guthrie of the UK鈥檚 Royal College of Obstetricians and Gynaecologists.
The Australian experience suggests UK and US regulations should be revised, says Murphy. 鈥淭elemedical abortion will not be for all women, and some may still want in-person care,鈥� she says. 鈥淗owever, it is an important advance in the development of woman-centred, accessible services.鈥�
Australian and New Zealand Journal of Obstetrics and Gynaecology
Related: Home abortions are safe 鈥� we should let women do it themselves
