Racial and demographic trends in abortion method selection in Minnesota among in-state patients at or under 11 weeks gestational duration, 2021-2024.

OBJECTIVE

Little is known about populations utilizing recently expanded access to telehealth medication abortion (TeleMAB) or how structural determinants may exacerbate access inequities. This study assesses demographic and racial trends between telehealth and in-clinic abortion patients with pregnancies 11 weeks or less in Minnesota.

STUDY

DESIGN

We conducted a retrospective cohort analysis using Planned Parenthood North Central States electronic health record data of Minnesota abortion patients at 11 weeks gestation or less between 2021 and 2024. Descriptive statistics and multinomial logit models results are reported using relative risk ratios.

RESULTS

A total of 20,360 abortions at or less than 11 weeks gestational duration occurred during the study period. 92.5% of the abortions were provided in person (64.9% medication, 27.6% procedural), and 7.6% were TeleMAB. TeleMAB patients were older, more likely to be white, live in rural counties, and have had a previous abortion compared to patients who received abortion care in person. Patients who self-identify as Black, Hispanic, multi-racial, or whose primary language is not English, are more likely to receive in-clinic care, specifically procedural abortions.

CONCLUSIONS

Telehealth expansion can improve abortion access for rural patients but may not reach other impacted communities in Minnesota. More research is needed to examine other structural barriers that may impede patients from selecting the abortion modality they prefer.

IMPLICATIONS: Telehealth abortion is key to retaining abortion access. However, this health care delivery shift has occurred concurrently with closures of brick-and-mortar clinics. Broadening telehealth and in-clinic care may support the autonomy patients seek in their reproductive care.