Demand for Self-Managed Medication Abortion Through an Online Telemedicine Service in the United States.

Abstract

<i>Objectives.</i> To examine demand for abortion medications through an online telemedicine service in the United States.<i>Methods.</i> We examined requests from US residents to the online telemedicine abortion service Women on Web (WoW) between October 15, 2017, and August 15, 2018. We calculated the population-adjusted rate of requests by state and examined the demographics, clinical characteristics, and motivations of those seeking services, comparing those in states with hostile versus supportive abortion policy climates.<i>Results.</i> Over 10 months, WoW received 6022 requests from US residents; 76% from hostile states. Mississippi had the highest rate of requests (24.9 per 100 000 women of reproductive age). In both hostile and supportive states, a majority (60%) reported a combination of barriers to clinic access and preferences for self-management. Cost was the most common barrier (71% in hostile states; 63% in supportive states; <i>P</i> < .001). Privacy was the most common preference (49% in both hostile and supportive states; <i>P</i> = .66).<i>Conclusions.</i> Demand for self-managed medication abortion through online telemedicine is prevalent in the United States. There is a public health justification to make these abortions as safe, effective, and supported as possible.