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Acceptability of no-test medical abortion provided via telemedicine during Covid-19: analysis of patient-reported outcomes
  1. Chelsey Porter Erlank1,
  2. Jonathan Lord2,3,
  3. Kathryn Church1
  1. 1Evidence to Action Department, MSI Reproductive Choices, London, UK
  2. 2Medical Director, MSI Reproductive Choices, London, UK
  3. 3Truro Locality, University of Exeter Medical School, Truro, Cornwall, UK
  1. Correspondence to Jonathan Lord, Medical Director, MSI Reproductive Choices, London W1T 6LP, UK; jonathan.lord{at}


Introduction The English government approved both stages of early medical abortion (EMA), using mifepristone and misoprostol under 10 weeks’ gestation, for at-home use on 30 March 2020. MSI Reproductive Choices UK (MSUK), one of the largest providers of abortion services in England, launched a no-test telemedicine EMA pathway on 6 April 2020. The objectives of this study were to report key patient-reported outcome measures and to assess whether our sample was representative of the whole population receiving no-test telemedicine EMA.

Methods A sample of all MSUK’s telemedicine EMA patients between April and August 2020 were invited to opt in to a follow-up call to answer clinical and satisfaction questions. A total of 1243 (13.7% of all telemedicine EMAs) were successfully followed-up, on average within 5 days post-procedure.

Results Patients reported high confidence in telemedicine EMA and high satisfaction with the convenience, privacy and ease of managing their abortion at home. The sample responding were broadly equivalent to the whole population receiving telemedicine. No patient reported that they were unable to consult privately. The majority (1035, 83%) of patients reported preferring the telemedicine pathway, with 824 (66%) indicating that they would choose telemedicine again if COVID-19 were no longer an issue.

Conclusions Telemedicine EMA is a valued, private, convenient and more accessible option that is highly acceptable for patients seeking an abortion, especially those for whom in-clinic visits are logistically or emotionally challenging. Evidence that this pathway would be a first choice again in future for most patients supports the case to make telemedicine EMA permanent.

  • abortion
  • induced
  • patient reported outcome measures
  • abortion
  • therapeutic
  • mifepristone
  • surveys and questionnaires
  • patient satisfaction

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  • Correction notice This article has been updated since it was published online. The title has been slightly amended with the words ‘during Covid-19’ being added.

  • Contributors CPE: data analysis, writing first draft and subsequent revisions, verification of data. Overall responsibility for data analysis and principal investigator. JL: initial concept, developing study protocol, writing first draft and subsequent revisions, co-ordination and liaison. Overall responsibility for conduct of study including data collection at MSUK. KC: data analysis, reviewing first draft and subsequent revisions, verification of data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests JL: co-author/committee member of national guidelines cited in this article from the Royal College of Obstetricians & Gynaecologists (RCOG) and the National Institute for Health and Clinical Excellence (NICE); co-chair of the RCOG Abortion Taskforce and the British Society of Abortion Care Providers (BSACP); primary employment includes work as an abortion care provider as a consultant gynaecologist and medical director.

  • 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.

  • Patient consent for publication Not required.

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

  • Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. Data tables are included within the article. Original raw data are archived on secure servers at MSI Reproductive Choices.