Tabbot Foundation in Australia offers a telephone abortion service

The Tabbot Foundation’s telephone abortion service, launched eight months ago, has so far provided more than 850 medical terminations, with many of its referrals coming from GPs.The procedure they follow starts with a referral for an ultrasound and pregnancy (blood) test. When results are confirmed, a phone consultation is organised with a gynaecologist or GP with family planning experience and, if required by state law, a clinical psychologist. Women eligible for a termination are mailed mifepristone and misoprostol pills as well as antibiotics, analgesics and anti-emetic drugs. A registered nurse and on-call doctor are available to guide them through the process by phone and for any follow-up. Another blood test is ordered 10 days later to confirm the termination was successful. The cost to patients is AU$250 after a Medicare rebate.The Foundation’s website is averaging about 120 hits a day and up to 90 phone calls a week, with an average of about 30 patients a week, according to medical director, Dr Paul Hyland, who described it as the way of the future for terminations.Half the referrals are being made by GPs, nurse practitioners, family planning clinics, sexual health clinics and mental health services. The other half are direct calls from women. The reasons why GPs may refer women to the Foundation may be due to not wanting to be on call 24 hours a day themselves, or because they are not seeing enough women to become comfortable with dealing with it. Jenny Ejlak, president of Reproductive Choice Australia, said it was also because of uncertainty over the law. At present, the Tabbot Foundation has to meet different legal requirements in every jurisdiction and is not allowed to provide the service in South Australia and Northern Territory.Most women have said they used the service for privacy reasons, particularly women in rural communities where there are few doctors and usually just one community pharmacy. About 15% of patients so far were living in rural and remote areas where there was limited access to abortion services. This was “a reflection of the inconsistent, inappropriate and in many cases antiquated legal frameworks governing abortion in Australia”, Ms Ejlak added.Data for 600 terminations carried out using the telephone scheme since its November launch to May showed that only 3 abortions had failed, 8 were incomplete, 8 required hospital attendance with excessive bleeding, and 4 needed additional analgesia.There have been 65 complaints to the Federal Department of Health, with none upheld. The service is being closely monitored because of restrictions on abortifacients.SOURCE: Australian Doctor, by Kathryn Ryan, 23 June 2016Campaign feature on the opening of the Tabbot Foundation, 20 November 2015PHOTO: The Tabbot Foundation website