{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:46:36Z","timestamp":1792683996939,"version":"4.5.0"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n In states that restrict abortion provision, residents rely on telehealth medication abortion (teleMAB) or travel out of state for in-clinic care; however, little is known about how patients using these modalities differ.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare characteristics of Kansas and Texas residents receiving teleMAB vs in-clinic medication abortion and to assess geographic and socioeconomic factors associated with modality of care.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective cross-sectional analysis used electronic medical record data for patients residing in Kansas or Texas who received medication abortion care from a teleMAB service or from an abortion facility in Kansas from February 1 to June 30, 2024. Patients younger than 18 years were excluded because only the telehealth site served this age group.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Patient sociodemographic characteristics (age, race and ethnicity, and number of children), gestational age, and county-level distance to the nearest abortion facility, social vulnerability, and rural-urban designation.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n The main outcome was receipt of teleMAB vs in-clinic care. Differences between patients who received teleMAB vs in-clinic care were assessed using \u03c7\n 2<\/jats:sup>\n and\n t<\/jats:italic>\n tests for bivariate variables and multivariable logistic regression for adjusted comparisons.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The teleMAB service served 12\u202f823 patients (Texas: n\u2009=\u200912\u202f552; Kansas: n\u2009=\u2009271); the clinic served 725 patients (Texas: n\u2009=\u2009587; Kansas: n\u2009=\u2009138). Mean (SD) age was 26 (6) years for Kansas residents and 27 (6) years for Texas residents. In both states, more telehealth patients self-identified as Hispanic, Latino, Latina, or Latine (Texas: 3739 of 12\u202f552 [32%]; Kansas: 48 of 271 [18%]) than in-clinic patients (Texas: 14 of 587 [3%]; Kansas: 8 of 138 [7%]) (\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). This difference remained among Texas residents after adjustment. In both states, compared with in-clinic patients, telehealth patients were more likely to be at less than 6 weeks\u2019 gestation (Texas: 7648 of 12\u202f552 [61%] vs 155 of 587 [27%]; Kansas: 159 of 271 [59%] vs 45 of 138 [33%];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and to have no children (Texas: 5545 of 12\u202f552 [44%] vs 42 of 587 [7%]; Kansas: 137 of 271 [51%] vs 5 of 138 [4%];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). In Texas, patients who lived farthest from in-clinic care were more likely to receive telehealth than those who lived shorter distances (average marginal effect, 0.003; 95% CI, 0.002-0.004).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cross-sectional study of patients who used medication abortion, teleMAB patients more often had no children, were living farther from an abortion facility, and represented populations facing structural racism and long-documented barriers to abortion care compared with in-clinic patients, particularly in abortion-restrictive states. A higher number of patients at lower gestational age received telehealth than in-clinic services, suggesting more convenient and timely care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.40034","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T15:30:34Z","timestamp":1792683034000},"page":"e2640034","source":"Crossref","is-referenced-by-count":0,"title":["Telehealth vs In-Clinic Medication Abortion Provision"],"prefix":"10.1001","volume":"9","author":[{"given":"Anna E.","family":"Fiastro","sequence":"first","affiliation":[{"name":"Department of Family Medicine, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin K.","family":"Thayer","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Southern California, Los Angeles"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha N.","family":"Fredman","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Stoa","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Manns","sequence":"additional","affiliation":[{"name":"Department of Social Sciences, State University of New York, Empire State University, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah B.","family":"Munro","sequence":"additional","affiliation":[{"name":"School of Public Health, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmalie","family":"Griswold","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Aiken","sequence":"additional","affiliation":[{"name":"Lyndon B. Johnson School of Public Affairs, University of Texas, Austin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Gomperts","sequence":"additional","affiliation":[{"name":"Women on Waves, Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy V.","family":"Norman","sequence":"additional","affiliation":[{"name":"Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily M.","family":"Godfrey","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Washington, Seattle"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"issue":"1","key":"zoi261085r3","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1002\/pam.22524","article-title":"Forecasts for a post-Roe America: the effects of 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Womens Health"},{"issue":"3","key":"zoi261085r21","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.contraception.2019.05.013","article-title":"TelAbortion: evaluation of a direct to patient telemedicine abortion service in the United States.","volume":"100","author":"Raymond","year":"2019","journal-title":"Contraception"},{"issue":"10","key":"zoi261085r22","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.38212","article-title":"Distance to care and telehealth abortion demand after Dobbs.","volume":"8","author":"Willerford","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"3","key":"zoi261085r23","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1111\/psrh.12280","article-title":"Pricing of medication abortion in the United States, 2021-2023.","volume":"56","author":"Upadhyay","year":"2024","journal-title":"Perspect Sex Reprod 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Guttmacher Institute. Accessed January 19, 2026. https:\/\/states.guttmacher.org\/policies\/?bans=total-abortion-ban"},{"key":"zoi261085r4","doi-asserted-by":"crossref","unstructured":"#WeCount report, April 2022 to June 2025. Society of Family Planning. December 9, 2025. Accessed January 19, 2026. https:\/\/societyfp.org\/wp-content\/uploads\/2025\/12\/WeCount-Report-10-June-2025-data.pdf","DOI":"10.46621\/750591yxmcwh"},{"key":"zoi261085r5","unstructured":"State bans on abortion throughout pregnancy. Guttmacher Institute. Accessed August 6, 2026. https:\/\/www.guttmacher.org\/state-policy\/explore\/state-policies-abortion-bans"},{"key":"zoi261085r8","doi-asserted-by":"crossref","unstructured":"Maddow-Zimmet? I, Forouzan? K. Full-year 2025 estimates show overall stability in abortion incidence, decrease travel and increase telehealth provision. Guttmacher Institute. March 2026. Accessed April 20, 2026. https:\/\/www.guttmacher.org\/report\/full-year-estimates-show-overall-stability-abortion-incidence-decreased-travel-increased-telehealth-provision","DOI":"10.1363\/2026.300866"},{"key":"zoi261085r12","unstructured":"Baden? K, DoCampo? I, Stoskopf-Ehrlich? E. States without total abortion bans see declines in clinician-provided abortions and out-of-state patients. Guttmacher Institute. September 30, 2025. Accessed January 19, 2026. https:\/\/www.guttmacher.org\/2025\/09\/states-without-total-abortion-bans-see-declines-clinician-provided-abortions-and-out-state"},{"key":"zoi261085r19","unstructured":"Barrow? A, Towne? C. Shield laws for reproductive and gender-affirming health care: a state law guide. The Williams Institute. August 2024. Accessed January 19, 2026. https:\/\/williamsinstitute.law.ucla.edu\/publications\/shield-laws-fact-sheets\/"},{"key":"zoi261085r27","unstructured":"Monthly Abortion Provision Study. Guttmacher Institute. 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