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  • Seeking online telemedicine abortion outside the jurisdiction from Ireland following implementation of telemedicine provision locally

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Original research
Seeking online telemedicine abortion outside the jurisdiction from Ireland following implementation of telemedicine provision locally
  1. Jo Greene1,
  2. Éadaoin Butler1,
  3. Catherine Conlon1,
  4. Kate Antosik-Parsons1,
  5. Rebecca Gomperts2
  1. 1 School of Social Work and Social Policy, Trinity College, Dublin, Ireland
  2. 2 Women on Web, Amsterdam, The Netherlands
  1. Correspondence to Dr Catherine Conlon, School of Social Work and Social Policy, Trinity College, Dublin, Ireland; conlonce{at}tcd.ie

Abstract

Background Abortion was legalised in Ireland in 2019 and telemedicine provision introduced in April 2020. We examined patterns in and reasons for seeking and receiving online telemedicine abortion outside the jurisdiction following legalisation and introduction of telemedicine abortion.

Methods Quantitative analysis compared frequency of contact, completed requests, service user characteristics and reasons for contacting Women on Web (WoW). Statistical analyses assessed if COVID-19 restrictions and the implementation of telemedicine abortion locally impacted on WoW contact patterns. Thematic analysis of email correspondence analysed reasons for seeking online telemedicine abortion.

Results There were 764 requests from Ireland to WoW in 2019–2020, with 225 (29.5%) completed. Requests declined by 90 (21%) between 2019 and 2020, and proportion of completed requests declined by 11.3% (n=70). During COVID-19 restrictions, the proportion of completed requests decreased even more (25%, n=24). Legal restrictions and cost declined as reasons for seeking online telemedicine and childcare, work/study commitments and being with partner/friend increased. During COVID-19 an abusive partner increased as the cited reason. Barriers cited in email correspondence included lack of proximate provider, not qualifying due to legal status and difficulty participating in consultations due to an abusive partner.

Conclusions Online telemedicine abortion seeking from WoW outside the jurisdiction reduced in the second year of legalisation. Local introduction of telemedicine abortion addressed reasons cited for seeking online telemedicine, other than abusive partner. Increasing awareness of abortion provision, particularly access pathways, free cost and confidentiality, promoting normalisation and retaining local telemedicine can reduce reliance on online telemedicine. Extending the format of local telemedicine abortion to include text-based contact could alleviate how an abusive partner impedes access.

  • abortion
  • reproductive health
  • reproductive rights
  • health policy

Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Women on Web (www.womenonweb.org) hold these data and may make fully deidentified data available to researchers on application.

https://doi.org/10.1136/bmjsrh-2021-201205

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    Data availability statement

    Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Women on Web (www.womenonweb.org) hold these data and may make fully deidentified data available to researchers on application.

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    Footnotes

    • Twitter @conlonce

    • Contributors CC, RG and JG planned and designed the study. RG generated study data. JG and EB cleaned study data, carried out data analysis and wrote up extended version of findings from which JG, EB, CC, KAP and RG developed discussion and conclusion. All authors contributed to revisions for final draft. CC submitted paper and is corresponding author. CC is guarantor for this article.

    • Funding EB, CC and KAP contribution to this study was undertaken while in receipt of funding from HSE Award Number 16123.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.