The Reproductive Health Training Center (RHTC) recently launched the first medical abortion via telemedicine service in Moldova. The goal of the project is to make medical abortion, a safe abortion method recommended by the World Health Organization (WHO), more accessible for women and girls facing diverse access barriers, such as those living in rural areas. The Covid-19 pandemic has amplified existing barriers and created new barriers limiting abortion access.

“The launch of this service is extremely timely. Access to abortion services has become extremely limited since the onset of the Covid-19 epidemic in Moldova. Many clinics have temporarily closed, women are unable to travel to regional gynecology departments with the suspension of interurban transportation, and the general message from public authorities is to stay home,” remarked gynecologist/obstetrician and RHTC director, Rodica Comendant.

The procedure for self-management of medical abortion implies the remote guidance of a trained medical provider through the following steps:

1. The patient accesses the website specially created for this service (avort.md/prin_telemedicina), determines the pregnancy term, and completes a short eligibility questionnaire.
2. Consultation from a trained gynecologist via telephone or videoconference.
3. Obtainment of abortion medications at a local pharmacy by presenting the electronic medical prescription written by the service provider. If the patient does not have access to a pharmacy, the medications will be sent via mail. During and after administering the medications, the patient can contact the provider regarding any questions that arise.
4. Follow-up will occur 1 week later via telephone or videoconference, in which the provider will assess the progression of the abortion and whether additional care is necessary.
5. Four weeks later the patient will take a pregnancy test to definitively evaluate abortion completeness.

Medical abortion via telemedicine was introduced in Moldova as part of the 2-year pilot project “Medical abortion via telemedicine for women and adolescents in rural Moldova: breaking barriers with technology”, in partnership with the Ministry of Health, Labor, and Social Protection’s Department of Primary Care, the State University of Medicine and Pharmacy “Nicolae Testemițanu,” Nr.1 Municipal Hospital in Chisinau, Women’s Health Center “Ana,” and Gynuity Health Projects. The project is supported by Grand Challenges Canada as part of the Options for Pregnancy Terminations (OPTions) Initiative and was approved by the National Ethics Committee for Clinical Trials in Moldova on October 10, 2019.[:]