Covid-19 has triggered an acute need to minimise the time patients spend in medical facilities and reduce contact between patients and providers. Gynuity recently led a collaborative development of a sample protocol for providing abortion pills without any routine facility-based tests either before or after treatment. They expect the no-test approach will continue to be beneficial after the epidemic ends by decreasing cost, enhancing convenience and facilitating new service delivery approaches.
There is an urgent need to revisit approved [package] inserts for medical abortion products in low- and middle-income countries to ensure information is accurate and reflects the current evidence base. Simultaneously, providing supplemental instructions targeted at users may fill some gaps. People have a right to accurate information to ensure a safe and effective medical abortion experience.
Providing medical abortions by telemedicine is safe, effective and feasible. Unscheduled communication with physicians was similar but unscheduled communication with clinic staff was more frequent […so ongoing access to support by text, phone or email seems a good idea]
Outcomes of medical abortion provided by advanced practice clinicians [mid-level providers] in our study are well within published benchmarks for effectiveness (95-99%) and safety (<1% complications) as when managed by physicians. Restricting provision to physicians only impedes access by excluding a large group of competent clinicians from offering this service.