Study Claims Tele-Medicine (Webcam) Abortions May Lower Complications: Authors’ Own Data Indicates a Potential 11% Increase in Complications
By Jacqueline Harvey, Ph.D.
Editor’s note. This first appeared at Reproductive Research Audit and is reprinted with permission.
The American Journal of Public Health has preliminarily released an electronic version of “Changes in Service Delivery Patterns After Introduction of Telemedicine Provision of Medical Abortion in Iowa,” a study which examines the effect that offering webcam-advised prescriptions for abortion pills has had on both the number of abortions and the demographics of women seeking abortions in Iowa. Daniel Grossman leads four other authors in this study, which employs a questionable unit of analysis and unsupported conclusions–namely that “Recent legislation to ban telemedicine abortion may adversely affect public health by preventing women from accessing abortion earlier in pregnancy, when it is safer.”
Even if the authors could support the claim that tele-medicine (or “tele-med”) contributed to the modest reduction in late-term abortions, they still fail to note medical abortions have greater rates of complications than surgical abortions. [“Medical abortions” is the term of art used to describe chemically-induced abortions.] The researchers only examine geography and service delivery, not safety or complication. However, by taking the number of abortions by type provided in the Grossman et al. study–and then considering the percentage of women facing complications from each abortion method (also provided by Grossman in this and previous articles), we were able to conclude the following:
According to Grossman’s figure and other literature, medical abortions are 60% more likely to result in complications (4% to 2.5%) compared to second-trimester abortions, but medical abortions in the first trimester are five times as likely to result in complications (2.5% to .5%). And Grossman et al.’s numbers show that following the launch of tele-med abortions, women who had previously chosen surgical abortions 52% over 48% are choosing the riskier substitute 54%-46%.
The 25 fewer late-term abortions in 2008-2010 only potentially spared one woman from adverse effects, but 15 more women likely suffered the adverse effects of medical abortions.
While the 21% of women receiving surgical abortions had qualified staff on site to address their complications that happened on-site, the remaining 79% of women face complications while self-administering the abortion drugs, and do so without medical attention.
Of the 15 total clinics that provide medical abortions, only 11 are equipped to provide the surgical follow-up required in many cases. The barriers that may prohibit women from visiting the 4 clinics that have physicians in-house for elective abortion may prevent them from receiving emergency care from a post-abortion complication.
Reproductive Research Audit’s full report details additional concerns with Grossman et. al’s methodology, and offers the data, sources formulas employed to calculate the results provided here. Please examine the full report for additional information.