Tele-Abortion:  Medical Abortion with The Abortion Pill 

via Tele-health

Medical Termination Of Pregnancy (MTOP) at home, for women who can't easily access in-clinic abortion services

Tele-Abortion - which is medical abortion by tele-health - introduction by Dr Emma Boulton, Managing Director of Clinic 66 in Chatswood.

Teleabortion is the delivery of abortion care for women seeking medical termination of early intrauterine pregnancy (not ectopic) via remote means. Early pregnancy  means a pregnancy under 9 weeks or 63 days from last menstrual period. Tele-abortion means that no face to face consultation with a doctor is required, as we communicate via phone, video and sms.

Teleabortion consists of at least two consultations (via video or phone) with experienced and skilled health professionals who will assess your situation, prescribe the relevant medications and follow you up according to best practice.

Medical termination of pregnancy (abortion) happens in the comfort of your own home, and usually without the need for further visits to medical professionals .

Medical Abortion by tele-health is a safe, effective, accessible & convenient alternative for early pregnancy termination. But its not without risk or discomfort. 

If you can get to our Clinic, it will be quicker, easier and cheaper to have medical abortion F2F.  This is because if you attend the clinic, we can do the scan, blood tests and dispense the medication on the same day. If you have medical abortion by tele-health you will need to organise the tests and medication yourself. 

How does Medical Abortion work?

The first step is a tablet which interrupts the pregnancy and then 24 hours later another tablet is taken which causes the uterus to contract and induces a miscarriage.

 

The second tablet does cause cramping (which can be severe) for about 6 hours, bleeding and passage of tissue. In about 95% of cases, this completes the pregnancy termination process.  

Pain does not usually continue beyond 6 hours after the second dose of tablets, though bleeding may continue for two to three weeks.

A follow-up assessment appointment (which is free of charge)  is essential to ensure that the Medical abortion process is complete.

How long does it take?

It is possible to complete the medical termination process within a few days but this will be dependent upon how quickly you will be able to get your required blood test and ultrasound done locally.

 

It is important that we have the test results before we can prescribe the medication. It is your responsibility to arrange to have the tests promptly. Once we have the results of the tests, we can proceed with the prescribing process.

 

Women undergoing medical termination of pregnancy must have an intrauterine pregnancy of under 63 days so if there is a delay getting the tests, and you are over 63 days gestation by the time the second consultation occurs,  then you will need to seek a surgical abortion with a local provider instead.

The Tele-Abortion Process

1
Understand

You read through all the info about medical abortion by tele-medicine to ensure that it is the right option for you and complete the suitability checklist. If all ok...

2
Register & Pay

You complete the registration and medical history forms, pay $150 and schedule your first consultation appointment asap

3
First Consultation

Your first consultation will take approx 45 minutes and will be done via video chat (skype, facetime, google meet or whatsapp) or by phone.

4
Test Requests

We send you your blood test and ultrasound request documents, We'll also give you access to your secure online TeleAbortion Consulting Room.

8
Medication Sent

The medication prescription is sent to a local pharmacy and you can either pick it up or have them send it to you

7
2nd Consultation

The second consultation will take approx 45 mins. You sign a consent form and agree a time for your medical abortion to begin

6
Schedule & Pay

We'll check everything we have to ensure that you are suitable for TeleAbortion.  If all OK, we'll let you know so you can schedule your 2nd appointment and pay $245

5
You have Tests

You arrange for and get your blood test and ultrasound done locally as soon as possible, and let us know as soon as they're done so we can follow up.

9
First Tablet

You take the first Mifepristone tablet which stops the pregnancy. You wait 24 hours for this medication to take effect before taking the second medication.

10
2nd Tablet

You take 4 Misoprostol tablets, which will induce a miscarriage. You will have cramping, pain & bleeding for approx 6hrs. Bleeding may continue for 2-3 weeks

11
Blood Test

10 days later, you organise your 2nd blood test to ensure that the procedure was successful.. You let us know when done and schedule your final appointment.

12
Final Consultation

Your final follow up appointment with the Doctor is important to make sure that all is well following the procedure. No charge for this appointment.

Note: There can be issues that may arise throughout this process, which could mean that your procedure won't go exactly as laid out here. All known potential risks are described in the information that you must read before committing to Medical Abortion via Tele-Health.

You must be under 9 weeks pregnant at the time of your medical abortion

(ie, under 63 days)

If you live in South Australia, unfortunately we can't help you, because Teleabortion is illegal in your state.

You must be within 2hrs of a hospital. Although complications are rare, we do need to be prepared.

If you live in Western Australia, you will require a referral from your GP. Contact us and we'll give you the details you need.

It is important that you tell someone you trust about what you are doing - just in case you need assistance.

If you live outside of Australia, you are under 16 yrs of age or you dont read English fluently, then you need to see a local provider face to face.

A medical termination may not be possible or might not be a good option for you if:

 

  • you are pregnant and might wish to continue with your pregnancy

  • your pregnancy is assessed as being of more than 63 days duration

  • you have a known or suspected ectopic pregnancy (a pregnancy outside of the womb)

  • you have known or suspected bleeding disorder

  • you are taking blood thinning medications (anticoagulants)

  • you are regularly taking steroid treatment for arthritis or asthma or any other illness that requires steroid medicines

  • your adrenal glands do not work very well

  • you have a known allergy to Mifepristone, Misoprostol or prostaglandins

  • you have an intrauterine contraceptive (IUD) still in the womb

  • you have an infection in the womb or fallopian tubes

  • you are already quite anaemic

  • you are NOT prepared to have a surgical procedure if needed 

 

How does Medical Abortion by Tele-health work?

1. Registration & First Consultation

Your TeleAbortion will require an initial payment for the registration process and first assessment appointment. You can make the appointment at a time that suits you, within our availability.

2. You get your blood test and ultrasound done locally

After the first appointment (initial assessment) we will give you blood test and ultrasound scan request forms so that you can get them done quickly and close to your home or work. As soon as they're done, you need to let us know.

 

These tests will ensure that you are suitable for medical termination of pregnancy, and provide a baseline so that we can best manage your personal journey through the medical abortion.

 

You will need to pay for these tests yourself (additional to the costs quoted by us), and prices will vary according to your local providers. If you hold a medicare card, you may be able to negotiate 'bulk billing'.

Important Note: It is critical that you get these tests done as quickly as possible. We cannot proceed until these tests are completed, as we must have the results before we can prescribe the medication. If you delay getting these tests, it is possible that the TeleAbortion will need to be canceled. If your pregnancy goes beyond 9 weeks (63 days) gestation, you will need to have a surgical abortion.

3. Second consultation and consent form

When the initial tests are complete, you will make and pay for the second appointment. During this second consultation, you will be assessed based on all the information you have  provided in the registration process and with the test results.

If all is ok, we will ask you to sign an electronic consent form so that we can prescribe the medications for a Medical Termination of Early Pregnancy via telehealth (ie TeleAbortion).

4. Prescriptions  sent to a pharmacy of your choice

A prescription will be sent to your choice of dispensing pharmacy. You will arrange with that pharmacist to either pick it up in person, or organise for them to send it to you (depending on your preferences and circumstances). The important thing is that we get the medication to you asap. You are the best person to decide whether to collect your medications in person or get the pharmacist to courier them to you.  You are responsible for the cost of all medications, including the  medical abortion pills. If you do not have a Medicare card, you will not receive a PBS benefit for the medical abortion pills, though your private health insurance may cover costs depending on your policy. 

5. You take the two-step medication as directed

 

Medical abortion happens in the comfort of your own home, without surgery or anaesthesia. Medical termination of pregnancy is usually safe and effective but is not without risks .

 

The first step is a tablet which interrupts the pregnancy and the second step to expel the pregnancy. The second step involves 4 tablets to be taken 24-48 hours after the first step. The tablets taken as the second step cause the uterus to contract and induce a miscarriage. This second step causes cramping, which may be severe, for about 6 hours, bleeding and passage of tissue.

 

The second step needs to happen in the morning, allowing the medical abortion process to occur throughout the day. In about 95% of cases, this is a straightforward process and safely completes the pregnancy termination.  

Pain does not usually continue beyond 6 hours after the second step,  though bleeding may continue for three weeks.

6. Follow up Test & Consultation

A follow-up blood test done at 10 days (which you need to get done locally again) and tele-consultation (which is free of charge), will be undertaken 3 weeks later. It is essential that this follow-up assessment occurs to ensure that the Medical Abortion process is complete.

Unfortunately there is no Medicare rebate or insurance rebate for Tele-abortion so the fees that you pay are not claimable or refundable.

Why do we offer this service?

There is international evidence to support the safety and effectiveness of teleabortion.

The Tabbot Foundation were the first providers of the teleabortion service in Australia  and when the Tabbot Foundation closed down recently, we felt we had to provide this service to fill the gap.

 

We decided to step up and assist women in Australia, who wish to undergo medical termination of pregnancy via telehealth. However, we receive no funding to provide this service. 

 

Unfortunately there is no Medicare rebate or insurance rebate for TeleAbortion so the fees that you pay are not claimable or refundable.

 

Access to safe and effective abortion services in Australia is highly variable. This inequality is unfair and un-Australian. We feel strongly that it is every woman's right to access safe and effective abortion care.

We also offer face to face consultations and service provision for abortion care (both Medical and Surgical) at Clinic 66 in Sydney, but for women who live far away or who are unable to access our services face to face we are pleased to be able to offer them Teleabortion.

How much does it cost?

 

The first consultation is $150, the second consultation is $245, both payable in advance. There is no fee for the follow-up appointment.

There are no rebates from Medicare for Tele-abortion. Women who are experiencing genuine financial difficulties should discuss that with us at the time of registration. 

 

If the medical abortion does not proceed, for any reason, or there are complications and further treatment is required, there is NO refund for the consultations provided. We will however continue your care until you have a satisfactory outcomes

What about privacy?

 

We take every step necessary in order to provide privacy and discretion for our service.  However telephones and video consultations are liable to hacking as with many other aspects of modern Life.  We use a secure payment gateway and offer Paypal payment options.

 

Like all responsible medical facilities, Clinic 66 rigorously protects your medical information, which is held on secure servers both online and offline.

Unplanned pregnancy = a difficult decision

We 100% support your choice & are here to Help!

 

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