Reasons for using telehealth medication abortion: adolescents and young adults compared with adults

While telehealth abortion is now widely available in the United States, research on adolescent and young adult (AYA) use of telehealth abortion is limited. We described AYAs' reasons for using telehealth for abortion and compared them to adults' reasons.

We analyzed survey data from 1,632 telehealth abortion patients (462 AYAs ages 16-24, including eight adolescents <18 years, and 1,170 adults >24) in 2021-2022. We used logistic regression to compare reasons between AYAs and adults. We also analyzed 462 open-ended AYA responses using inductive thematic analysis and deductive coding.

AYAs (ages 16-24) were more likely than adults (ages 25+) to cite lower costs (67% vs. 55%; p<0.001) and fear of what would happen at a clinic (27% vs. 16%; p<0.001) as reasons for using telehealth. Conversely, AYAs were less likely than adults to use telehealth to avoid arranging child or dependent care (10% vs. 18%; p<0.001), because of COVID-19 concerns (7% vs. 13%; p=0.002), or because they liked the company mission (27% vs. 33%; p=0.034). Qualitative responses reinforced these findings, highlighting themes of financial constraints, privacy, transportation, and conflicts with school or work. Among AYA participants, 158 (34%) mentioned both telehealth-related reasons and reasons related to their young age (e.g., parental concerns, being in school, or lack of transportation due to age).

Telehealth abortion successfully served AYAs who reported compounded financial, logistical, and privacy-related barriers to in-person care. Expanding access to telehealth abortion may help AYAs continue to overcome these barriers.

ClinicalTrials.gov (NCT04432792).