Durban — The study done by academics at the UCT and the Karolinska Institutet – a research-led medical university in Stockholm, Sweden, into accessing safe abortion services in South Africa has revealed that telemedicine abortion is safe, effective and a viable alternative to the conventional medical procedure, especially for women in under-resourced settings.
Scientists drew these and other conclusions after completing the world’s first randomised control trial (RCT) into the efficacy of telemedicine abortion – a medication-based abortion that generally relies on a two-drug combination and is aimed at women in their first trimester.
According to Dr Margit Endler, a consultant in obstetrics and gynaecology at Karolinska Institutet and an adjunct senior researcher in UCT’s School of Public Health and Family Medicine, abortion is an essential part of a woman’s reproductive rights.
Endler said access to abortions remained restricted in South Africa despite the country’s liberal abortion laws. She said the trial specifically targeted women in rural communities where ultrasound scans were not easily accessible in clinics, or where the service was not within reach.
“We are very proud because this is the first RCT performed on telemedicine abortion and is also just one of a handful of studies that investigates telemedicine abortion in low-resourced settings. We are thrilled with the results, which show that this model for abortion care is safe and effective when compared to the standard care option. This research opens up new avenues of access to care, especially for women who have limited access to healthcare,” Endler said.
She said approximately 900 pregnant women who needed access to medical abortions at public health facilities in Cape Town participated in the clinical trial.
“The first group of participants (450) were randomly selected for the standard care option and received an in-person consultation with a healthcare worker (HCW). The HCW performed an ultrasound to assess the stage of the pregnancy and later facilitated the abortion in the clinic,” said Endler.
She said the remainder of the participants (450), were required to complete an online questionnaire that was reviewed by a doctor, and once the patient was approved to proceed with terminating the pregnancy, she received four separate messages via Facebook Messenger detailing what to do at home.
She said these messages also included guidelines on what to expect after taking both pills and highlighted the red flags patients needed to look out for. Thereafter, the patient was required to visit the clinic where a nurse palpated her uterus in preparation for the abortion and supplied both abortion pills to take home.
“We found that this asynchronous online consultation and instruction for medical abortion, with uterine palpation as the only in-person component, followed by home self-medication, was non-inferior to standard care. It also did not affect safety, adherence or satisfaction,” Endler said.
Daily News