{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:58:23Z","timestamp":1787241503816,"version":"build-2736575974"},"reference-count":15,"publisher":"BMJ","issue":"e1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2021,3,15]]},"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Medical abortion provided via telemedicine is becoming more widely available, potentially decreasing travel time for in-person abortion evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective chart review of all outpatient medical abortions from October 2016 through December 2019 at our academic medical centre in Portland, Oregon, USA. Using mifepristone administration logs, we identified patients who underwent abortion via direct-to-patient telemedicine or in clinic. Both groups had pre-abortion ultrasound examination. We extracted patient characteristics and geographic data to compare travel distance to clinic, ultrasound facility, and nearest advertised abortion clinic. We compared time from first contact until mifepristone ingestion and gestational age at mifepristone ingestion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median distance from mailing address to clinic for 80 telemedicine and 124 clinic medical abortions was 95 (range 4\u2013377) and 12 (range 0\u2013184) miles (p&lt;0.01). Distance travelled to ultrasound facility was shorter for telemedicine patients (median 7 miles, range 0\u2013150 vs 12 miles, range 0\u2013184; p&lt;0.01) excluding outliers &gt;200 miles. Distance to nearest advertised abortion clinic was equal between groups (median 7 miles, p=0.4). Time to mifepristone administration (ingestion) was longer (11 vs 6\u2009days; p&lt;0.01) and median gestational age was higher (49 vs 44 days; p=0.01) for telemedicine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Telemedicine increases the reach of abortion providers and provides care to more geographically distant patients. Patients chose telemedicine abortion even when they had an equidistant option, suggesting that patients value telemedicine for reasons other than geographic convenience. This telemedicine delivery model that included ultrasound testing prior to abortion resulted in up to a 5-day delay in abortion initiation, which was not clinically significant.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjsrh-2020-200972","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T13:28:24Z","timestamp":1617197304000},"page":"e38-e43","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Miles and days until medical abortion via TelAbortion versus clinic in Oregon and Washington, USA"],"prefix":"10.1136","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7067-1497","authenticated-orcid":false,"given":"Kathleen Marie","family":"Beardsworth","sequence":"first","affiliation":[{"name":"Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uma","family":"Doshi","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Raymond","sequence":"additional","affiliation":[{"name":"Gynuity Health Projects, New York, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen K","family":"Baldwin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"key":"2025090512293124000_48.e1.e38.1","unstructured":"Jones RK WE , Jerman J . Abortion incidence and service availability in the United States, 2017 2019."},{"key":"2025090512293124000_48.e1.e38.2","unstructured":"U.S. Food and Drug Administration (FDA) . Approved risk evaluation and mitigation strategies (REMS): Mifeprex (mifepristone). U.S. FDA: Silver Spring, MD, 2016."},{"key":"2025090512293124000_48.e1.e38.3","doi-asserted-by":"crossref","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"},{"key":"2025090512293124000_48.e1.e38.4","doi-asserted-by":"crossref","DOI":"10.7326\/M20-6671","article-title":"Ensuring safe access to mifepristone during the pandemic and beyond","volume":"174","author":"Brown","year":"2021","journal-title":"Ann Intern Med"},{"key":"2025090512293124000_48.e1.e38.5","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301097"},{"key":"2025090512293124000_48.e1.e38.6","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1001\/jamainternmed.2016.0573","article-title":"Increasing access to abortion with telemedicine","volume":"176","author":"Raymond","year":"2016","journal-title":"JAMA Intern Med"},{"key":"2025090512293124000_48.e1.e38.7","doi-asserted-by":"crossref","DOI":"10.1016\/j.conx.2020.100023","article-title":"Comparing telemedicine to in-clinic medication abortions induced with mifepristone and misoprostol","volume":"2","author":"Wiebe","year":"2020","journal-title":"Contracept X"},{"key":"2025090512293124000_48.e1.e38.8","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.contraception.2019.08.010","article-title":"Characteristics of patients having telemedicine versus in-person informed consent visits before abortion in Utah","volume":"101","author":"Daniel","year":"2020","journal-title":"Contraception"},{"key":"2025090512293124000_48.e1.e38.9","doi-asserted-by":"publisher","DOI":"10.1363\/psrh.12024"},{"key":"2025090512293124000_48.e1.e38.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"2025090512293124000_48.e1.e38.11","unstructured":"United States Census Bureau . 2010 Census urban and rural classification and urban area criteria: United States Census Bureau, 2019. Available: https:\/\/www.census.gov\/programs-surveys\/geography\/guidance\/geo-areas\/urban-rural\/2010-urban-rural.html [Accessed 12 Jun 2020]."},{"key":"2025090512293124000_48.e1.e38.12","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1177\/1536867X1801700411","article-title":"A simple command to calculate travel distance and travel time","volume":"17","author":"Weber","year":"2017","journal-title":"Stata J"},{"key":"2025090512293124000_48.e1.e38.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)10170-3"},{"key":"2025090512293124000_48.e1.e38.14","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.contraception.2017.11.005","article-title":"Simplified medical abortion screening: a demonstration project","volume":"97","author":"Raymond","year":"2018","journal-title":"Contraception"},{"key":"2025090512293124000_48.e1.e38.15","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.contraception.2020.04.005","article-title":"Commentary: No-test medication abortion: a sample protocol for increasing access during a pandemic and beyond","volume":"101","author":"Raymond","year":"2020","journal-title":"Contraception"}],"container-title":["BMJ Sexual &amp; Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2020-200972","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T19:29:40Z","timestamp":1757100580000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2020-200972"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,31]]},"references-count":15,"journal-issue":{"issue":"e1","published-online":{"date-parts":[[2021,12,17]]},"published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1136\/bmjsrh-2020-200972"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2020-200972","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,31]]}}}