Telemedicine is an effective modality for remote family planning care delivery. Telemedicine increases reach, reduces barriers to care, and facilitates person-centered care. As the demand for telemedicine increases, evidence-based guidance is crucial for optimal practice. This clinical guidance series offers evidence-informed, person-centered, and equity-driven recommendations to enhance telemedicine delivery of contraceptive services and medication abortion in the US. Providing care via telemedicine may not be for everyone, and thus, clinicians should take a person-centered approach to ensure telemedicine meets the needs of the person receiving care. Ensuring that telemedicine remains accessible, regardless of whether a person also requires in-person clinical services, is essential to person-centered family planning care. Telemedicine family planning services should be integrated across practice settings and codesigned with persons from marginalized communities to ensure services are linguistically appropriate, equitable, and accessible. Clinicians should engage in implementation and advocacy efforts that combat health, digital, and structural inequities contributing to disparities in telemedicine family planning care access. Telemedicine family planning care should address the privacy and confidentiality of the person receiving care. Telemedicine family planning care clinicians should be familiar with their state, regional, and institutional laws or regulations regarding abortion care and, more broadly, telemedicine before providing care. Where uncertainty exists, clinicians should consult a lawyer experienced in telemedicine and abortion care.

This Clinical Recommendation provides evidence-informed, person-centered, and equity-driven guidance to optimize contraceptive care via telemedicine in the United States. Recommendations include offering the following contraceptive services via telemedicine: contraceptive counseling, initiation, renewals for methods not requiring procedural placement, and follow-up care for symptoms or complication management not requiring physical exam (GRADE 1B). The person receiving care should have the option to choose their preferred telemedicine service delivery mode, including audio-video, audio-only, or asynchronous care. When prescribing combined hormonal contraceptives (CHCs), we suggest clinicians provide clear guidance on how to remotely collect and report blood pressure measurements, why these data are important, and the availability of alternative contraception options if an unacceptable health risk is identified (GRADE 2C). We recommend prescribing a 1-year supply of CHCs without requiring follow-up within that year unless requested by the person receiving care (GRADE 1A). We recommend progestin-only methods as safe and effective options for telemedicine and self-administered contraception provision (GRADE 1A). We recommend a hybrid approach combining telemedicine and in-person care for long-acting reversible contraception (LARC) methods (GRADE 2B). However, it is important to maintain the option for same-day, in-person LARC provision without requiring prior telemedicine counseling.

Forthcoming