International Campaign for Women's Right to Safe Abortion
20 November 2015

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18 November 2015
Feature: The Tabbot Foundation - A ustralia'snewtele-health medical abortion provider

"The Tabbot Foundation has been established to provide an Australia-wide telephone consultation home medical termination of pregnancy service. Abortion has been revolutionised by the use of new medications which have been available throughout the world for more than a decade but have been restricted for use in Australia until more recently. In July 2013, after years of banning this drug's importation into Australia by previous governments, Tanya Plibersek, as Minister of Health, approved the listing of the abortion drug mifepristone on the Pharmaceutical Benefits Scheme. Plibersek described the provision of the medicine as 'a good thing in the situation where women are faced with one of the most difficult decisions that they will ever make'.
"Mifepristone has been safely used by millions of women in more than 50 countries who have had access to it for several years. It is a safer, less invasive procedure than the alternatives not just because it can be performed much earlier than surgical abortions, but because it can be done safely in the privacy of a woman's home without surgical intervention.
"The expansion of access to medical terminations by tele-medicine is particularly important to women living in rural and regional Australia. These women have to travel long distances or indeed travel interstate to undergo surgery or not had the option of surgery at all.
"Home-based medical abortion is intended to simplify the medical abortion regimen without compromising safety. Home-based medical abortion improves the acceptability of medical abortion by allowing for greater privacy than in-clinic abortion and giving women greater control over the timing of the abortion. In reports from France, Sweden, Tunisia and the United States, the majority of women opted for home-based medical abortion when offered the choice. Self-administration of the drugs is already common in France and the United States."
The website of the service gives detailed, step-by-step instructions on taking the pills and other medications, information about symptoms and side effects, and a page of frequently asked questions with straightforward answers. See:
"We are very excited about this new service"
On 27 September 2015, the day of the launch, Reproductive Choice Australia wrote: "We are very excited by this new Australian service launched today. The Tabbot Foundation is a team of experienced abortion care providers who are utilising tele-health-style methods to deliver medical termination of pregnancy across Australia."
Reproductive Choice Australia believe the foundation cannot offer services to the NT, SA, ACT due to laws in those jurisdictions, but that in the rest of Australia you just need a phone and to be close enough to medical services to get pathology and ultrasound done, and the medications are posted to you.  ( )
The restriction may be that in some states in Australia, women seeking a termination are required to undergo a psychological assessment, and that would remain the case under the Tabbot scheme, according to yet another report, but the assessment would also be done over the phone. ( ) Another report said the service was "legal across the nation". ( )
According to several of these news reports, the cost of a medical abortion would be halved with this service. Women will be referred to a local provider for blood tests and an ultrasound, and, if the pregnancy is viable and less than 63 days, she will be mailed the pills, prophylactic antibiotics, painkillers and anti-nausea drugs - all for A$250. There will also be a 24-hour helpline. ( ) One report said that the $250 was the cost with a Medicare card, and it would be $600 otherwise. ( ) Medicare is a publicly funded universal health care scheme in Australia and all residents and some visitors are eligible.
Podcast on the day of the launch
A podcast of an interview with Reproductive Choice Australia Co-president Jenny Ejlak clarifies more of the details of the new service and is worth listening to: . She talks about the fact that tele-health services are already being used successfully for other health services in Australia as well. She also explains that the service was pilot-tested for several months in Tasmania in advance of the national launch, which went well.
Overwhelming response from women within a few days of the launch
On 30 September, four days after the launch, in an article in the Sydney Morning Herald, the medical director of the service was reported to say that they had been so overwhelmed by prospective patients they could not meet the demand. The service had received enquiries from four times the number of women it was able to treat, and was trying to find alternative services for some women.
Reproductive Choice Australia Co-president Jenny Ejlak said the number of calls to the Tabbot Foundation "should be a wake-up call" for the government. She also called for the national reproductive health strategy that had been published as long ago as 2008, to be implemented, with the aim of reducing unintended pregnancies and ensuring the best care for women with fertility issues. The strategy was drafted by the Public Health Association of Australia, the Australian Women's Health Network and the Family Planning Alliance of Australia, and supported by every major health body in the country, she said, but to no avail.
The Tabbot Foundation Medical Director Paul Hyland said since the launch of the telephone service, its free phone number, 1800 180 880, had received an average of 50 calls a day, while its website had had about 1,200 hits a day. They had been expecting to treat between eight and 10 new patients a day.
"Until further notice, in cases where we cannot provide a service to a woman within 48 hours, they will be directed to their closest medical provider, where pregnancy termination services are known to exist." He said Tabbot would focus on providing its service to women in rural and remote regional areas, who were unable to access abortions any other way.
Another service, Cairns Doctors, can also prescribe the drugs using video consultations done through Skype, but one of the organisation's doctors, Heather McNamee, said the service was small and was unlikely to be able to meet the excess demand nationally. Dr McNamee said she preferred to use Skype because she wanted to be able to see the women she consulted with.
Post-script: then the media went quiet
Apart from about half a dozen anti-abortion articles decrying the new service in the week after the launch, the media went quiet. Let's take that to mean everything is going very well!! This is a milestone in abortion service delivery, worth emulating across the world.