”I was unemployed, had no health insurance and I was in no position to raise a baby”, says an anonymous young woman in the UK. Imagine not being able to access Sexual and Reproductive Health (SRH) services. Imagine the fear, the stigma, and the resulting risks you will take to terminate your unintended pregnancy. During the Covid-19 pandemic, many girls and women are facing these fears. Though Colombia might be able to break this halt to abortion care throughout the Covid-19 pandemic through it’s frontrunning position in providing telemedicine options!
With the Covid-19 pandemic spreading around the globe, many countries force SRHR services to close, because they are not classified as “essential”. Between 2015 and 2019, roughly 121 million unintended pregnancies occurred each year. 61% of these unintended pregnancies ended in abortion. This translates to 73 million abortions per year.Due to the pandemic, the UNFPA predicts an additional 7 million abortions due to the pandemic .
With numerous SRH services closed and inadequate access to care, the world is potentially facing thousands of additional deaths from unsafe abortion and complicated births. This pandemic is blocking women and girls from accessing services. To make the situation even worse, it’s also further distancing women and girls from already difficult-to-access SRH care.
Good news from Colombia though! Colombia, a country where abortion was legalized in 2006, introduced a comprehensive abortion through telemedicine system right at the start of the pandemic. What a timing! Orientame, an abortion clinic situated in Colombia, has launched this service named “teleabortion” on the 27th of March 2020.
Pre-Covid-19, they discovered an unprecedented interest in self-managed abortion from people with unwanted pregnancies and from the formal healthcare systems and policymakers.
So, since the 27th of March, they have been providing abortion through telemedicine services all over the country. Their focus lies on self-managed medication abortion. Meaning, the practice of self-sourcing of abortion medicines, followed by self-use of the medicines including self-management of the abortion process outside of a clinical context.
At this moment in time, Orientame has achieved to provide, 24/7 personal online support, access to early abortion, services spread around the whole country, direct consultation with an expert professional, avoidance of a waiting room, 100% confidential care, and even more.
Orientame shows significant results in providing their telemedicine abortion service, and so far, 255 women have received medical abortion via email. In addition to medication for the treatment of abortion, users of the Orientame service also receive preventative SRH services:
• A contraceptive method of choice.
• A pregnancy test and brochure with instructions for use.
• Condoms to encourage the use of double protection.
• Versions printed in the patient’s name of the medical formulas where medications and the contraceptive method of choice are prescribed.
• Information brochures and guides with recommendations on drug management, alarm signs and symptoms. As well as information for the use of painkillers and the contraceptive method.
Is Colombia’s teleabortion a success store? Should we all follow Orientame’s lead to increase long term results in SRH care? We know that countries like Australia, India, the UK, and the USA have previously introduced abortion telemedicine protocols in their health systems. From various personal global experiences, we have learnt that personal medical care is not essential during the first trimester of pregnancy, because a first evaluation can be easily performed from a distance. This means that the introduction of abortion through telemedicine can decrease the pressure on our already overwhelmed health systems, and therefore help us in times of war and pandemic. But most importantly, this service assists in the actual access of SRH services. The importance of avoiding death by unsafe abortion treatment, has never been as high.
Growing evidence shows that abortion through telemedicine has immense potential. Existing challenges, regarding the delivery of proper SRH services, face the global south as well as the global north. By following Colombia’s teleabortion initiative, we might be able to increase our beliefs in the quality and positive effects of telemedicine. Health systems might be able to introduce first semester abortion through telemedicine and help those who are in need of Sexual and Reproductive Health Rights support.