Access to and acceptability of telemedicine medication abortion in primary care
Awarded 2021
Innovations in medication abortion service delivery
Silpa Srinivasulu, MPH
Reproductive Health Access Project

COVID-19 prompted healthcare organizations to innovate and adopt novel models for delivering abortion to their patients safely and with minimal contact. This project studies patients’ experiences of COVID-19-related telemedicine abortion, including mifepristone delivery, and examines the extent to which telemedicine shifted abortion access for patients served by the Cambridge Health Alliance (CHA) primary care network in Boston, MA. Our findings will inform innovative, patient-centered telemedicine medication abortion delivery models that center preferences for patient-provider communication and location of care. Our findings will show that when mifepristone restrictions are loosened, no-test telemedicine abortion and mifepristone delivery is acceptable, feasible, and safe to provide in primary care clinics operating within large health systems. Our diverse, multidisciplinary team of senior and junior clinicians/researchers will conduct in-depth interviews to explore patients’ experiences of primary care-based telemedicine abortion, examining acceptability and best practices for patient-provider communication. We will also analyze de-identified chart data to compare demographics, pregnancy characteristics, and need for clinical support among those who sought medication abortion services in-clinic (before) with telemedicine/mifepristone delivery (during) the pandemic. Our team represents an authentic partnership between an advocacy organization (the Reproductive Health Access Project), a community health system (CHA), and an academic institution (University of Washington), and includes a carefully-planned mentorship component to help build the next generation of diverse family planning leaders. We will disseminate our findings widely throughout RHAP’s clinician networks, the University of Washington’s 5-state primary care research network, and in primary care and reproductive health-related journals and conferences.