Society of Family Planning Clinical Recommendation: Telemedicine in family planning care part 2 - Abortion.

This Clinical Recommendation provides evidence-informed, person-centered, and equity-driven guidance to optimize medication abortion management via telemedicine in the US. Key recommendations include: We recommend telemedicine medication abortion with or without pre- or posttreatment testing as a safe option before 12 0/7 weeks of gestation. No-test telemedicine medication abortion (NTMA) and hybrid models are shown to be safe and effective (GRADE 1B). We recommend over-the-counter nonsteroidal anti-inflammatory agents as the first line for pain management for telemedicine medication abortion with consideration of opioids as needed when providing telemedicine medication abortion care (GRADE 1C). We recommend principles of noncoercive person-centered communication be applied to meet the abortion counseling needs of the person receiving care (GRADE 1B). We suggest assessing the person's desire for contraceptive counseling at the time of telemedicine medication abortion and, depending on the preference of the person receiving care, either defer it to a later time to allow for deliberation and increased autonomy or provide contraceptive counseling if desired (GRADE 2C). We recommend assessing telemedicine medication abortion completion using a standardized patient symptom checklist (such as the sample validated checklist in Table 2) two weeks after mifepristone ingestion in conjunction with a home pregnancy test (GRADE 1C). This document builds upon the Society of Family Planning Committee Statement: Telemedicine in family planning care part 1 - Background and overarching principles and parallels recommendations outlined in the Society of Family Planning Clinical Recommendation: Telemedicine in family planning care part 3 - Contraception. Readers are encouraged to review parts 1 and 3 for this additional context.