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.
Now, a new "tele-abortion" service aims to change that. Abortion Online, launched this week, provides medical termination consultations online or over the phone, removing the need to travel to an abortion clinic in person.
Here's how it works:
During these 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 under 9 weeks gestation and within a two hour drive of emergency care, the service arranges for a prescription for abortion medications Mifepristone (also known as RU-486) and Misoprostol to be sent to a local pharmacy.
The woman can then collect this medication locally or have it posted to her, allowing her to undergo an abortion in the privacy of her own home. Medical abortions using Mifepristone and Misoprostol effectively induce a miscarriage, and are safe and effective options for terminating an early-stage pregnancy.
The new service was launched this week by Dr Emma Boulton, the Director of Sydney-based sexual and reproductive health clinic Clinic 66.
'Abortion Online' services are available to women in all Australian states, except South Australia where at-home abortions are not legal.
Boulton says Abortion Online aims to fill a "major gap" in abortion service accessibility in Australia, following the closure of similar tele-abortion service the Tabbot Foundation earlier this year.
"Though abortion has finally been decriminalised in NSW, there is a long way to go in order to provide women in Australia with comprehensive abortion care," Dr Boulton said, pointing out that abortion clinics tend to be clustered around major cities.
In Australia, due to the tyranny of distance, there's a real postcode lottery in terms of access to abortion.
"I'd say that abortion is an essential part of the health service. It's a woman's human right to be able to access good healthcare."
Unfortunately for women in rural and regional areas, tele-abortion services are expensive.
Abortion Online's $395 fee covers three consultations with a medical professional, plus unlimited aftercare for women who experience complications following the procedure.
This fee does not include the blood test, ultrasound or medication itself, which range in cost depending on a woman's access to health insurance and Medicare. Mifepristone and Misoprostol are listed on the Pharmaceutical Benefits Scheme, and cost $40 for those with a Medicare card, or over $300 with those without Medicare.
"If a woman can come to the clinic, we strongly recommend that she does so because it's cheaper and easier," said Dr Boulton.
"But if she happens to live in a rural or regional area of NSW where she just can't access that service locally, we want to give her the option of accessing care online."
Dr. Boulton told The Feed that Abortion Online had been designed with financial sustainability in mind.
"It's not an easy service to provide," she said. "We're not making a profit, but we've done some business planning showing what the costs are."
Other organisations like Marie Stopes and some reproductive health clinics also provide tele-abortion services in Australia. Dr. Boulton said that Abortion Online hopes to make the digital process of understanding and accessing tele-abortion easier by providing clear, detailed resources on its website.
"Trial feedback has been very positive. All of the women so far have lived in rural or regional parts of NSW, all of them have been over 300 kilometres away from Sydney."
"We're making sure that we follow them up carefully in terms of outcomes and satisfaction."
