Medical abortion by telemedicine or standard care in South Africa: A randomized controlled non-inferiority trial 

  University of Cape Town                     South Africa

Physician-supervised telemedicine for medical abortion has not been studied in a low-resource setting. This innovation will use a randomized clinical non-inferiority trial to compare the efficacy, safety and acceptability of a telemedicine option for medical abortion to standard abortion care. Women requesting abortion at less than 9-weeks gestation will be recruited, screened, and randomized 1:1 into one of two groups: 1) standard care, in which women receive an ultrasound and in-person counselling, and 2) telemedicine, in which women do not have an ultrasound and receive counselling through Women on Web´s online application SafeAbortion. In both groups, the community health centers will provide the basic physical exam and the abortion medication, and the success of the abortion will be confirmed with a clinical symptom list and pregnancy test. Non-inferiority will be assessed for efficacy, and safety and acceptability will be evaluated as secondary endpoints.