The Tabbot Foundation was one of the first tele-abortion services, which had to shut down earlier this year due to funding problems. For women in rural and regional Australia, accessing abortion services can be costly and a logistical nightmare, requiring hours of travel to reach a clinic.
A new tele-abortion service, called Abortion Online, was launched in mid-October 2019 in New South Wales, which provides medical abortion consultations online or over the phone, removing the need to travel to an abortion clinic in person.
During phone consultations, a qualified medical professional advises a woman on the options available to her, and guides her through the process of arranging a blood test and ultrasound. Once the medical professional determines that the woman meets the criteria for a tele-abortion, such as being over age 16, under nine weeks gestation and within a two-hour drive of emergency care, the service arranges for a prescription for abortion medications mifepristone and misoprostol to be sent to a local pharmacy.
The woman can collect these medications locally or have them posted to her, to have an abortion in the privacy of her own home. The service is available to women in all Australian states except South Australia, where at-home abortions are not legal.
The service was launched by Dr Emma Boulton, director of Sydney-based Clinic 66. “Though abortion has finally been decriminalised in New South Wales, there is a long way to go in order to provide women in Australia with comprehensive abortion care.” Abortion clinics in Australia tend to be clustered around major cities, meaning that rural women are at a big disadvantage.
Patients can book online by filling out a consent form, detailing their medical history. They watch a set of explanatory videos both before they get the pills and before they take them.
Unfortunately, Abortion Online’s tele-abortion services are expensive, quite a bit more expensive than the Tabbot Foundation’s were. Their $395 fee covers three long-distance consultations with a medical professional, plus unlimited aftercare for women who experience complications (though this will be rare). The fee also does not include a pregnancy test, a chlamydia test, nor an ultrasound, nor the abortion pills themselves. These “extras” range in cost depending on a woman’s access to health insurance. Mifepristone and misoprostol cost just under $40 on the Pharmaceutical Benefits Scheme, only $6.40 for those with a healthcare card, but over $300 for everyone else. Still, Dr Boulton says the service is not making a profit.
She says, as the Tabbot Foundation said too, that tele-abortion care is not an easy service to provide because of the costs involved. “Trial feedback has been very positive. All of the women so far have lived in rural or regional parts of New South Wales; all of them have been over 300 km away from Sydney. We’re making sure that we follow them up carefully in terms of outcomes and satisfaction.”
A few other reproductive health clinics have also begun to provide tele-abortion services in Australia. The Tabbot Foundation were covering women in all states except South Australia when they closed down, so Clinic 66 and others have some way to go to replace them.