Abortions have always been controversial, but nothing could be more controversial than online abortion prescriptions. We’ve investigated this new development, and strangely enough, it seems the experts are all for it.
The idea behind telemedicine is to give patients more privacy when it comes to sensitive procedures. ‘Telemedicine as a whole makes sense for many types of doctor consultations,’ says US sex expert, Dr Ian Kerner. ‘In many cases, telemedicine can provide timely, professional expertise to patients without access or financial resources.’ In this case, he says, it enables a woman to continue to make a responsible choice that impacts her body and her life.
If you want to get an abortion in the US, you can now participate in video telemedicine conferences with a qualified doctor who will make sure you get what you need at the click of a button (literally). However, before you can sign up for this one-on-one online interaction, you will need to be examined by a nurse at one of a handful of participating clinics, who will give you an ultrasound and give you access to the clinic’s Internet connection. The doctor on the other side of the screen will have a copy of your medical records and will judge, via Skype, whether or not it is safe to prescribe you an abortion pill, known as mifepristone or RU-486.
‘Offering mifepristone to women in a clinic via a video-conceding consultation with a doctor or an in-person attending nurse is a practical and resourceful approach to dealing with the matter of abortion,’ says Kerner.
Clinical sexologist Dr Marlene Wasserman disagrees and doesn’t believe telemedicine is the way to go when it comes to abortion. ‘The purpose of visiting a health care provider is to be able to have a safe, professional space in which your doctor asks you a lot of questions and you ask a lot of questions and in this way a good history is taken of your whole life, context and circumstances,’ she says. ‘Medicine today is based on "integrative treatment," which means that a doctor treats the whole person, not just the presenting problem. How can the health care provider possibly make such a huge decision based on a woman who, at that moment, is in distress, crisis and may sorely regret her decision [later]?
‘South African law dictates that a woman receives pre-termination counselling in order to give her the professional space to work through her decision, choices and consequences of a termination.’
Cape Town-based psychologist and sex and relationship expert, Dr Claire Rockliffe-Fidler, thinks that as long as women are examined and counselled adequately, this programme could be beneficial. ‘If all is well and the indications are still to proceed, then it isn’t a problem.’
While the key to telemedicine is privacy, it is important that women go for a follow-up appointment at their clinics about a week after taking the abortion pill. ‘This process also needs to involve supportive and reflective counselling,’ says Rockliffe-Fidler. ‘Terminations can be a very traumatic experience for some women and they need to be adequately prepared for the process and for the emotional adjustment thereafter.’ While it is possible for some women not be affected at all, she adds, this is not always the case.
Rockliffe-Fidler believes in medicine’s new, modern approach to consultations, but thinks it needs to be cautious too… especially when it comes to delicate matters dealing with abortions and a woman’s wellbeing.