Medical abortion by teleconsultation, a sustainability that raises questions



Initially authorized due to the health crisis, medical abortions by teleconsultation have just been made permanent by a government decree, published on Saturday February 19. The law extending the deadline for abortion from twelve to fourteen weeks of pregnancy, which must be voted on this Wednesday, February 23, also plans to perpetuate the extension of the deadline for recourse to such abortions from five to seven weeks of pregnancy, as it has been since April 2020.

From now on, women no longer have to go to the doctor to have a medical abortion, which represented 72% of the total of 220,000 abortions performed in France in 2020 according to a study by DREES. A teleconsultation is enough, and the necessary drugs can be withdrawn from the town pharmacy. “A monitoring follow-up, within fourteen to twenty-one days, is also ensured”, adds Adrien Gantois, president of the National College of Midwives.

According to him, this practice has changed the situation in terms of access to care for these women: “Some can be taken by time and it is sometimes difficult to access practitioners. You can have weeks of waiting and in the case of abortions, the longer you wait, the more complicated it is. This practice therefore makes it possible to have a rapid, concrete and medically certified response. »

If the teleconsultation “is one of the rare advances of the Covid”according to Joëlle Belaisch Allart, president of the National College of French Gynecologists and Obstetricians, she nevertheless calls for caution regarding abortions: “The teleconsultation goes much faster than a physical meeting. We don’t talk the same way. »

From experience, the gynecologist knows well that at the last minute, when saying goodbye, a patient will very often say: “By the way doctor, I didn’t tell you…”“This is one of the important aspects that we do not find in video. Whenever possible, it is therefore preferable for the woman to consult a professional to carry out her medical abortion. she recommends.

The gynecologist also insists on the need to do an ultrasound with a professional before performing an abortion. “in the vast majority of cases”. The objective is to know if the pregnancy is ectopic or not, in other words if it develops outside the uterus. If that is the case, “the medicine won’t work”. That said, she specifies, it is always possible to see a professional by teleconsultation after having done an ultrasound. ” One does not prevent the other “, adds Joëlle Belaisch Allart.

For his part, Adrien Gantois insists on the complementarity of teleconsultation with a face-to-face meeting, “which remains in the majority”, he assures. The objective, he specifies, is not to replace the physical consultation, “but to simplify access to medical abortion and to ensure that women are supported as best as possible”. Like a classic medical consultation, the teleconsultation “can also be the way to approach the different methods of contraception in addition to providing information adapted to the person’s situation”, he adds.

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