PRESS RELEASE | Telemedicine can help improve access to abortion in France, a new study suggests
For immediate release 29/07/2021
A new study published in the British Medical Journal Sexual & Reproductive Health suggests that telemedicine abortion provision, a temporary measure which is allowed in France within the context of the COVID-19 pandemic, can help meet women’s needs and preferences for secrecy, privacy and comfort, while facilitating increased access to and enabling a more person-centred abortion care beyond the pandemic.
Marion* writes to Women on Web: “I know abortion is legal in France, but I will tell you why I will not be able to have an abortion here. My companion is a violent man, I will never be able to have the opportunity to go to a hospital or a centre without him watching me.”
Abortion access still remains tenuous for some women in France. A recent study conducted with Women on Web data at the Sciences Po Laboratory for Interdisciplinary Evaluation of Public Policy (LIEPP) shows that women continue to encounter obstacles while trying to access abortion care in France. The study found that younger women aged 18-25 are two times more likely to perceive abortion stigma and to encounter financial difficulties, compared to women who are 36 years old and above. They are, however, also two times more likely to find at-home abortion via telemedicine empowering.
Why women choose at-home abortion via tele-consultation?: Drivers beyond the pandemic
The study shows that while lockdowns served as a push factor for women to resort to telemedicine in France, increasing the demand for abortion via tele-consultation, the drivers of telemedicine are multidimensional and go beyond the conditions unique to the pandemic. The preferences and needs over secrecy (46.2%), privacy (38.3 %), and comfort (34.9%), followed by coronavirus pandemic (30.6%), were among the most frequent reasons for women from France to choose telemedicine abortion through Women on Web. Researchers also noted a willingness for self-management of abortion, with 28.6% of study participants indicating they rather self-manage their abortion as the reason why they prefer a tele-consultation.
Telemedicine abortion provision in France is now extended until September 2021 and can be practised until 7 weeks of pregnancy. Women can book appointments online and purchase the abortion pills from a pharmacy (under exceptional delivery notation) to self-manage their abortions at-home without the direct supervision of a medical practitioner. Prior to the pandemic, medical abortion was authorized up to 5 weeks and telemedicine was not allowed. The medical abortion pills were not available in pharmacies and women were required to go to a clinic, hospital or a family planning centre and take the first abortion medication in the presence of a medical practitioner.
Telemedicine abortion: A game-changer for women
The World Health Organization (WHO) supports self-management of medical abortion up to 12 weeks of pregnancy. The WHO further suggests that self-management of abortion is safe, acceptable and cost-effective, and also improves autonomy as individuals might value the sense of control over their bodies and the abortion process, as well as the ability to maximize comfort being at home while taking pills. The French National Authority for Health emphasizes that “access to abortion must be quick and easy; medical consultations prior to abortion can be done face-to-face or by tele-consultation, with the woman's consent and if the doctor or midwife deems possible.”
“Telemedicine can be a game-changer for some women” says the study’s lead author, Hazal Atay, research assistant at Sciences Po LIEPP.
“Previous research has shown that telemedicine abortion in early pregnancies is safe, effective and acceptable, and has the same success rate as in-clinic abortion. Our research suggests that extending telemedicine abortion care beyond the pandemic and embracing a hybrid model that offers both in-clinic and telemedicine abortion, can help meet women’s preferences and needs better, improving both access and the quality of care” Atay explains.
The study is available open access: https://srh.bmj.com/content/early/2021/07/28/bmjsrh-2021-201176
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*The name was changed to protect anonymity.