Telemedicine abortion service to expand access to care

 Whomever you are and wherever you live in Aotearoa New Zealand, you have the right to end a pregnancy if you want or need to. One way to do so is through early medical abortion, which uses pills and allows for self-managed abortion at home. This option has been available via telehealth for some time but has become more common in recent years, especially since the start of the COVID-19 pandemic. 

 A new service called DECIDE, launched in April by the Ministry of Health, is helping to expand existing telehealth services and close overall gaps in access to abortion care. DECIDE provides consultations and medications for early medical abortions, along with related services, including consultations, information, referrals, counselling, and after-care support. This service cannot replace in-person care, which will always be necessary in certain cases, but helps to enlarge access to safe and timely abortion. This is a great step forward for equitable sexual and reproductive healthcare. 

 There is a growing evidence base on telehealth abortion services, especially due to its increased of rollout across the globe due to COVID-19 restrictions. International research shows that telehealth abortion care is extremely safe and effective. Self-managed medical abortion conducted by telehealth is just as safe and effective as when the procedure is completed in person at a doctor’s office, clinic, or hospital. This option is not associated with higher risks of complications compared with pills accessed in-office. In fact, only 2% of medication abortions result in complications, and most of those are minor. Plus, most patients report being satisfied with their experience.

The research also suggests several advantages to telehealth abortion services, namely:

  • allow more privacy and autonomy (avoid harassment, conscientious objection, disclosing choice if unsafe)
  • help ensure timely care
  • greater flexibility reduces burdens of cost, travel, and time
  • reduce pregnancy-related deaths


 Telehealth services are especially beneficial to those who may not otherwise be able to access abortion care. This may be due to low resources, disability, caregiving or work responsibilities, or geographical distances, especially if disclosing an unintended pregnancy is difficult or unsafe. Indeed, researchers report that barriers limiting abortion access most profoundly affect communities that already face health care and social inequities and can therefore widen existing socio-economic inequalities.

 It is also important to note that access to early medical abortion through telehealth ensures timely care. While abortion is among the safest medical procedures, the earlier it is done, the fewer complications there could be. Reducing wait times for abortion, which has been a major problem in the past, can also help alleviate some of the stresses associated with unintended pregnancy.

The country is already seeing higher rates of earlier access to abortion and the final rollout of the DECIDE services will hopefully maintain this trend and contribute to more equitable access to sexual and reproductive healthcare for all.

National Abortion Telehealth Service a step toward equitable reproductive healthcare

File:Abortion pill.jpg - Wikimedia Commons
Early medical abortion involves using two medications to end a pregnancy – mifepristone and misoprostol. (Image: VAlaSiurua via Wikimedia Commons)



ALRANZ Abortion Rights Aotearoa commends the Ministry of Health’s plan for a funded national abortion telehealth service as a significant step toward expanding access to abortion care.



“This service will address some of the current inequities in abortion access, especially for those who have to travel long distances. As seen during the pandemic, abortion telehealth helps ensure timely care and reduces burdens of cost, travel, and time,” says ALRANZ spokesperson Dr Tracy Morison. The service will help reduce gaps in reproductive healthcare for low-income, Māori, Pacifica, and disabled people.



Following the COVID-19 pandemic, self-managed telemedicine abortion has increased globally. It has been demonstrated to be as safe and effective as when conducted in person in a medical facility. New Zealand’s service will provide consultations and medications for early medical abortions along with related services, including consultations, information, referrals, counselling, and after-care support.



In addition to helping reduce access barriers, telehealth abortion services provide consumers with privacy. Although support for abortion law reform is widespread, stigma persists. Morison says telehealth services allow consumers to avoid harassment, conscientious objection, or disclosing their choice if it is unsafe to do so.



ALRANZ applauds the national abortion telehealth service’s aim of providing free and flexible options and consumer-driven pathways. This initiative helps promote equitable sexual and reproductive healthcare for all New Zealanders.