NEWS

WHO Guidelines Encourage Telehealth Abortion Care

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Key Takeaways

  • The WHO released new abortion guidelines recommending telemedicine for medication abortions.
  • Some abortion care providers said this new guidance reiterates that all approved abortion methods are safe and effective.
  • But many U.S. states have banned telemedicine appointments for abortion care or prohibited all forms of abortion. Some patients would have to travel to another state for an appointment.

For the first time, the World Health Organization (WHO) recommend the use of telemedicine for abortion pill prescriptions in its abortion care guidelines. Some healthcare providers say the new guidance reinforces the message that all approved forms of abortion are safe and important.

“​​The WHO recommendations confirm that unnecessary regulations placed on abortion care in many settings, including the U.S., do nothing to make abortion safer,” Melissa Grant, chief operations officer of FemHealth USA at carafem, an organization that provides telehealth and in-person abortion care across the United States, wrote in an email to Verywell.

Abortion regulations in some states continue to stand in the way of safe and effective reproductive health care, Grant said.

In its new guidance, the WHO stated that abortion pill prescriptions via mail delivery should be offered as alternatives for in-person appointments, and that both options should be prioritized. The organization also emphasized the need to provide patients access to scientifically accurate and clear information, quality medication, referrals to additional support, and contraceptive services after the abortion if requested.

What Else Is New in the WHO Guidelines?

In addition to promoting access to online abortion pill prescriptions, WHO recommended increased access to pain treatment for patients seeking abortions, including:

  • Certain pain management for both medical and surgical abortion, in addition to already-recommended non-steroidal anti-inflammatory drugs (NSAIDs), with exact recommendations varying on abortion type and timing.
  • Cervical priming before surgical abortions, paired with additional pain medicine suggestions varying on timing.
  • A combination regimen of letrozole and misoprostol, two drugs sometimes used in medical abortions, as a safe and effective option for medical abortions at earlier than 12 weeks, noting that the combination may be safe for people up to 14 weeks into a pregnancy.
  • A combination regimen of mifepristone and misoprostol as favorable over just misoprostol for medical management of a missed abortion (a miscarriage in which the fetus remains in the uterus) at fewer than 14 weeks.
  • Advice against anti-D immunoglobulin, a medication that is used to prevent hemolytic disease of the newborn, for both medical and surgical abortions.

Barriers to Medication Abortion

In December 2021, the Food and Drug Administration (FDA) permanently removed the in-person requirement for picking up abortion medication.

During the pandemic, many people have faced financial hardship, decreased access to transportation, and other challenges in seeking abortion care, Grant said. “Being able to receive medically supported abortion pills at home makes abortion more accessible for many people,” she added.

Studies have found that some abortion clinics were understaffed, had limited hours, or faced shutdowns for not being considered “essential businesses” throughout the pandemic. The barriers to care have also disproportionately affected Black and Hispanic abortion seekers.

Multiple states place limits on abortion care or telehealth access to abortion care. Some states are working to significantly reduce access to both medical and procedural abortions after a few weeks into a pregnancy. In Texas, abortions are now prohibited after as few as six weeks into a pregnancy. In Florida, the governor is expected to sign a bill that would prohibit abortion after 15 weeks into a pregnancy.

“The FDA’s decision to make abortion pills permanently available by mail has helped ensure better access for many people, but it is not enough,” Grant said. “Restrictions unnecessarily delay care, increase costs, and are a burden for those with the least resources in our country.”

At least 19 states have restricted the mailing of abortion pills or prescribing abortion pills through telemedicine, according to Axios.

Telemedicine Abortion Care Today

Carafem offers telehealth services for abortion care to residents in 11 states: Connecticut, Georgia, Iowa, Illinois, Massachusetts, New Jersey, Nevada, Rhode Island, Virginia, Vermont, as well as Washington, D.C. The company is unable to send the pill to patients who reside elsewhere. As a result, patients in states that restrict abortion care often travel for appointments, Grant said.

“We have clients who drive to our centers for abortion care, birth control, and health screenings from neighboring states, just as people travel to find other goods and services that may not be available to them locally,” she added. “They can also drive into a state that allows telehealth abortion to receive care outside of a medical office if they choose.”

In addition to abortion care, carafem offers birth control and screenings for sexually transmitted infections. In addition to telehealth, carafem runs in-person health centers in Atlanta, Chicago, Nashville, and Washington D.C.

Of all the services offered, medication abortion appointments are in highest demand, according to Grant. More than half of the carafem clients choose to use an abortion pill, she said.

People who are prescribed the pill via telehealth appointments will first learn about their medical options through a secure video conferencing system before having the medications shipped to their home or a secure location, Grant added.

“We want to provide options for people who prefer to have a medically supported abortion at home in every state where it is not restricted,” Grant said. “People deserve the right to be involved in the decision-making process of when, how, and where they receive health care. Abortion care at home is a part of that and we’re working to expand this service to all states that allow it.” 

Awaiting the potential impact of WHO’s guidance, Grant affirmed the need for multiple options for abortion care.

“As the WHO report shows, abortion is safe, whether you go to a clinic, have a telehealth visit, or even self-manage your own abortion at home,” Grant said. “People should be able to choose the type of medical care that best meets their individual needs.”

What This Means For You

For now, people who are in need of abortion care can connect with providers virtually if they are in a state that permits abortion care telehealth appointments. In some cases, patients may travel to a neighboring state that allows for virtual appointments for abortion care.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. World Health Organization. Abortion care guideline.

  2. Wolfe T, van der Meulen Rodgers Y. Abortion during the COVID-19 pandemic: racial disparities and barriers to care in the USA. Sex Res Social Policy. Published online March 22, 2021. doi:10.1007/s13178-021-00569-8

By Claire Wolters
Claire Wolters is a Philly-based reporter covering health news for Verywell. She is most passionate about stories that cover real issues and spark change.