A telemedicine model for abortion in South Africa
Women on Web’s research collaboration in South Africa was focused on creating a controlled, randomized trial which compared standard abortion care with a telemedicine model for those seeking medical abortion. The research aimed at investigating the safety and effectiveness of a modified telemedicine protocol for abortion in a low resource setting as opposed to the standard practices in place.
Between February 28, 2020, and October 5, 2021, the trial recruited participants from four different public health clinics, all seeking medical abortion at or before 9 weeks of pregnancy. The participants were then randomly allocated to a standard care group or a telemedicine group. The standard care group was given in-person consultation and instruction with an ultrasound then received 200mg of mifepristone at the clinic and 800 mg of misoprostol to take at home. By contrast, the telemedicine group received online consultation and instruction, self-assessed the length of their pregnancy, and took both medicines at home. The participants were assessed for abortion completion after 6 weeks.
The outcomes of the trial revealed that approximately 95.4% of the telemedicine group had a complete abortion – based on two analytical methods – compared with 96.6% of the standard care group. The risk assessments of the two groups resulted in a difference of approximately -1.1%, based on the two methods.
The trial ultimately revealed that the telemedicine group was non-inferior to standard care with respect to complete abortion rates. It also showed the online consultation and instruction, the gestational self-assessment, and the self-administering of the medicines did not affect safety, effectiveness, or satisfaction of care.
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